Active NPI
Lauren Pectyo Namsupak, DDS
- Endodontics
- Morgantown, WV
National Provider Identifier
1578728457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 3832
- Practice address
- 3412 University Ave
Morgantown, WV 26505-7220 - Phone
- (304) 381-3331
- NPI assigned
- Jul 21, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3832 | WV | |
| Endodontics | 1223E0200X | DS038864 | PA | |
| Endodontics | 1223E0200X | 3832 | WV | Primary |
Addresses
Primary practice location
3412 University Ave
Morgantown, WV 26505-7220
Mailing address
3412 University Ave
Morgantown, WV 26505-7220
Phone (304) 381-3331
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS038864 | PA | MD | Endodontist |
| 3832 | WV | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460678400000",
"number": "1578728457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3412 UNIVERSITY AVE",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265057220",
"telephone_number": "304-381-3331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3412 UNIVERSITY AVE",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265057220",
"telephone_number": "304-381-3331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAMSUPAK",
"first_name": "LAUREN",
"middle_name": "PECTYO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-21",
"last_updated": "2016-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WV",
"license": "3832",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "PA",
"license": "DS038864",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WV",
"license": "3832",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.