Individual provider Active NPI

Matthew Christopher O'Dell, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hurricane, WV
National Provider Identifier
1689971962
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
3824 Issued in WV
Practice address
3518 Teays Valley Rd
Hurricane, WV 25526-9235
Phone
(304) 562-1000
NPI assigned
Feb 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 3824 WV Primary

Addresses

Primary practice location

3518 Teays Valley Rd
Hurricane, WV 25526-9235

Mailing address

3518 Teays Valley Rd
Hurricane, WV 25526-9235
Phone (304) 562-1000

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
3824WVMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew C O'Dell, DDS, PLLC Orthodontics and Dentofacial Orthopedics CurrentSince Sep 28, 2021 Accepting new patients
Crout & O'Dell Orthodontics Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Locations

3518 Teays Valley Rd
Hurricane, WV 25526
Phone (304) 562-1000

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": "1298332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1689971962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3518 TEAYS VALLEY RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269235",
            "telephone_number": "304-562-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3518 TEAYS VALLEY RD",
            "city": "HURRICANE",
            "state": "WV",
            "postal_code": "255269235",
            "telephone_number": "304-562-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'DELL",
        "first_name": "MATTHEW",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-22",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WV",
            "license": "3824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurricane, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.