Danielle Larae Mace, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4070 Issued in WV

Practice address

250 Venture Dr
Morgantown, WV 26508-7301

Phone

(304) 241-4992

Fax

(304) 241-4023

NPI assigned

Jul 31, 2013

Last updated

Dec 1, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417392000000",
    "number": "1609208743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 VENTURE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265087301",
            "telephone_number": "304-241-4992",
            "fax_number": "304-241-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 VENTURE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265087301",
            "telephone_number": "304-241-4992",
            "fax_number": "304-241-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACE",
        "first_name": "DANIELLE",
        "middle_name": "LARAE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-31",
        "last_updated": "2014-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynx West VA, LLC (Lynx EMS)
• John Anthony Lyon
• Oksana Lytvyn
• Majed Youssef Maalouf, M.D.
• Andrew H Mace Jr., M.D.
• Kevin J Mace, M.D.
• Zachary David Mace, D.D.S.
• Eva Macfarland
• Pierre Mack
• Karen Mackay, M. D.

• General Practice Dentistry in Morgantown, WV
• Providers in Morgantown, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.