Jebediah S Christy, D.D.S. - Vienna, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

4081 Issued in WV

Legal business name

JEBEDIAH S CHRISTY, D.D.S. - VIENNA, PLLC

Practice address

501 Grand Central Ave
Vienna, WV 26105-2140

Phone

(866) 273-8204

Fax

(866) 803-4943

NPI assigned

Jun 30, 2014

Organization subpart

No

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

Authorized official

Name

Jason Bertollini

Title

PRS

Phone

(866) 273-8204

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1629483466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3189",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132203189",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 GRAND CENTRAL AVE",
            "city": "VIENNA",
            "state": "WV",
            "postal_code": "261052140",
            "telephone_number": "866-273-8204",
            "fax_number": "866-803-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEBEDIAH S CHRISTY, D.D.S. - VIENNA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "BERTOLLINI",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRS",
        "authorized_official_telephone_number": "866-273-8204"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WV",
            "license": "4081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Hutchinson
• Heather Inclenrock
• Brandi Jackson
• Jayda Marie James
• Betty Jarvis
• Lori Jenkins
• John David Rogers
• Karen Johnson
• Curtis Jones
• Emily Marie Jones, BS

• Dentist in Vienna, WV
• Providers in Vienna, WV by specialty
• Dentist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; 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.