Elizabeth Lague Wakim, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4075 Issued in WV

Practice address

234 Court St
Clarksburg, WV 26301-2906

Phone

(304) 623-4984

NPI assigned

Jul 23, 2013

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

Other names 1

• Dr. Elizabeth Antoinette Lague Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Samantha Jette DDS - Professional Corporation

  • General Practice Dentistry
  • Clarksburg, WV
  • NPI 1902666415
  NPD (past)
• Thomas E Condron DDS

  • General Practice Dentistry
  • Clarksburg, WV
  • NPI 1457415135
  NPD (past)

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374537600000",
    "number": "1689016339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 NEW CASTLE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084261",
            "telephone_number": "414-467-7368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 COURT ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012906",
            "telephone_number": "304-623-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAKIM",
        "first_name": "ELIZABETH",
        "middle_name": "LAGUE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "LAGUE",
            "middle_name": "ANTOINETTE",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tekisha Dehaven Waddell
• Kimberly Sue Waggy, MA;EDS
• Angela D Wagner, LICSW
• Cristina Suzanne Wagoner, REGISTERED NURSE
• Ruth Wagoner
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP.
• Kurt J Walck, PHARM.D.
• Walgreen Co
• Amber Lynn Walker, MBA

• General Practice Dentistry in Clarksburg, WV
• Providers in Clarksburg, 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 Jul 23, 2013; 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.