Individual provider Active NPI

Malinda Maynard Husson, DDS, MSD

  • Pediatric Dentistry
  • Charleston, WV
National Provider Identifier
1629134317
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
3557 Issued in WV
Practice address
4502 Maccorkle Ave SE Ste C
Charleston, WV 25304-1835
Phone
(304) 926-9260
Fax
(304) 926-9266
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401410708 VA
Dentist 122300000X 3557 WV
Dental Anesthesiology 1223D0004X 3557 WV
Anesthesiology Physician 207L00000X 0401410708 VA
Pediatric Dentistry 1223P0221X 3557 WV Primary

Addresses

Primary practice location

4502 Maccorkle Ave SE Ste C
Charleston, WV 25304-1835

Mailing address

4502 Maccorkle Ave SE Ste C
Charleston, WV 25304-1835
Phone (304) 926-9260

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
3557WVMDDentist Anesthesiologist
0401410708VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Malinda M Husson, DDS, PLLC Pediatric Dentistry CurrentSince Mar 6, 2022 Accepting new patients
Don E. Skaff, DDS, Inc. Pediatric Dentistry PastSince Mar 6, 2022 Accepting new patients

Locations

4502 Maccorkle Ave SE
Ste C
Charleston, WV 25304
Phone (304) 926-9260

Organizations & group practices 2

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1629134317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 MACCORKLE AVE SE STE C",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041835",
            "telephone_number": "304-926-9260",
            "fax_number": "304-926-9266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 MACCORKLE AVE SE STE C",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041835",
            "telephone_number": "304-926-9260",
            "fax_number": "304-926-9266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUSSON",
        "first_name": "MALINDA",
        "middle_name": "MAYNARD",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410708",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3557",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "WV",
            "license": "3557",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0401410708",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WV",
            "license": "3557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.