NPIMap

Organization Active NPI

Capitol Endodontics, PLLC

  • Endodontics
  • Charleston, WV
National Provider Identifier
1518330463
Registry record updated Nov 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
4180 Issued in WV
Legal business name
CAPITOL ENDODONTICS, PLLC
Practice address
405 Capitol St
Suite 914
Charleston, WV 25301-1749
Phone
(304) 345-1248
NPI assigned
Nov 1, 2015
Last updated
Nov 1, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amanda Boustany, D.D.S., M.S.D.NPI 1710327556
Title
Owner
Phone
(304) 345-1248

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 4180 WV Primary

Addresses

Primary practice location

405 Capitol St
Suite 914
Charleston, WV 25301-1749

Mailing address

405 Capitol St
Suite 914
Charleston, WV 25301-1749
Phone (304) 345-1248

National Provider Directory

National Provider Directory

Locations

405 Capitol St
Ste 914
Charleston, WV 25301
Phone (304) 345-1248

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1446336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446336000000",
    "number": "1518330463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 CAPITOL ST",
            "address_2": "SUITE 914",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011749",
            "telephone_number": "304-345-1248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 CAPITOL ST",
            "address_2": "SUITE 914",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011749",
            "telephone_number": "304-345-1248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOL ENDODONTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-01",
        "last_updated": "2015-11-01",
        "status": "A",
        "authorized_official_last_name": "BOUSTANY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-345-1248",
        "authorized_official_credential": "D.D.S., M.S.D."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WV",
            "license": "4180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.