Triadelphia of West Virginia Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TRIADELPHIA OF WEST VIRGINIA DENTAL PLLC

Practice address

219 Cabela Dr
Triadelphia, WV 26059-1022

Phone

(304) 909-3019

NPI assigned

Sep 9, 2020

Organization subpart

No

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

Authorized official

Name

George Monios

Title

Owner

Phone

(304) 909-3019

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687219200000",
    "number": "1538774401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70887",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441900887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 CABELA DR",
            "city": "TRIADELPHIA",
            "state": "WV",
            "postal_code": "260591022",
            "telephone_number": "304-909-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIADELPHIA OF WEST VIRGINIA DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A",
        "authorized_official_last_name": "MONIOS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-909-3019"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.