Individual provider Active NPI

Philip M Majestro, D.D.S.

  • General Practice Dentistry
  • Charleston, WV
National Provider Identifier
1609913755
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3193 Issued in WV
Practice address
830 Oakwood Rd
Charleston, WV 25314-2010
Phone
(304) 344-4003
Fax
(304) 720-2393
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3193 WV Primary

Addresses

Primary practice location

830 Oakwood Rd
Charleston, WV 25314-2010

Mailing address

830 Oakwood Rd
Charleston, WV 25314-0000
Phone (304) 344-4003

Other identifiers 2

IdentifierTypeStateIssuer
000830081OtherWVBLUE CROSS BLUE SHIELD
0134101000MedicaidWV

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160506001990 WV Order and Referring Only - DentistPractitioner - Dentist 1052610367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3193WVMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Nagy & Majestro, D.D.S., Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609913755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 OAKWOOD RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253140000",
            "telephone_number": "304-344-4003",
            "fax_number": "304-720-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 OAKWOOD RD",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253142010",
            "telephone_number": "304-344-4003",
            "fax_number": "304-720-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAJESTRO",
        "first_name": "PHILIP",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000830081",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0134101000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.