Individual provider Active NPI

Hebah Kassar, DDS

  • General Practice Dentistry
  • Fairmont, WV
National Provider Identifier
1699344911
Registry record updated Jun 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4528 Issued in WV
Practice address
403 Virginia Ave
Fairmont, WV 26554-2748
Phone
(304) 366-3910
NPI assigned
Jun 21, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2021

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 4528 WV Primary

Addresses

Primary practice location

403 Virginia Ave
Fairmont, WV 26554-2748

Mailing address

241 Raven Run
Morgantown, WV 26508-9297
Phone (304) 685-7539

Other practice location 1

1016 Maple Dr
Morgantown, WV 26505-0385
Phone (304) 599-6550

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
4528WVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Wilson and Martino of Fairmont, PLLC PastSince Jun 27, 2021 Accepting new patients
Michael F Trent & Michael J Meador DDS Inc PastSince Jun 27, 2021 Accepting new patients
Dr. K. Paul Wilson, PLLC General Practice Past Accepting new patients

Organizations & group practices 3

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": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624233600000",
    "number": "1699344911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 RAVEN RUN",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265089297",
            "telephone_number": "304-685-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 VIRGINIA AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265542748",
            "telephone_number": "304-366-3910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1016 Maple Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265050385",
            "country_code": "US",
            "telephone_number": "304-599-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KASSAR",
        "first_name": "HEBAH",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairmont, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; 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.