Alex Richard Pancake, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

4515 Issued in WV

Practice address

9000 Coombs Farm Rd Ste 304
Morgantown, WV 26508-1150

Phone

(304) 771-1861

NPI assigned

Jun 30, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722816000000",
    "number": "1598335689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 COOMBS FARM RD STE 304",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081150",
            "telephone_number": "304-771-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 COOMBS FARM RD STE 304",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081150",
            "telephone_number": "304-771-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCAKE",
        "first_name": "ALEX",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2024-08-05",
        "certification_date": "2024-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS044547",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WV",
            "license": "4515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jan E Palmer, M.D.
• Rachel Palmer
• Ronda Palmer
• Emma Palova, M.D.
• Samantha Pan, MHS, PA, ASCP
• Joel Liju Panicker, PA-S
• Chance Dennis Panter, DO
• Helen Ann Panzironi, LGSW
• James Derek Panzone, MSW
• Kelly Pape, RN

• Endodontics in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Endodontics in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2024; 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.