Richard Diaz, DDS Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2571 Issued in WV

Legal business name

RICHARD DIAZ, DDS INC.

Practice address

115 S Charles St
Charles Town, WV 25414-1613

Phone

(304) 725-4492

Fax

(304) 725-9700

NPI assigned

Jul 22, 2006

Organization subpart

No

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

Authorized official

Name

Richard Diaz, DDSNPI 1760406706

Title

President

Phone

(304) 725-4492

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Nelson Diaz, DDS

  • General Practice Dentistry
  • Charles Town, WV
  • NPI 1760406706
  NPD (past) Authorized official
• Christopher Mason Payne

  • General Practice Dentistry
  • Charles Town, WV
  • NPI 1538785522
  NPD (past)
• Vicki L Woodyard, DDS

  • General Practice Dentistry
  • Charles Town, WV
  • NPI 1801817952
  NPD (past)

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700807856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S CHARLES ST",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254141613",
            "telephone_number": "304-725-4492",
            "fax_number": "304-725-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 S CHARLES ST",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254141613",
            "telephone_number": "304-725-4492",
            "fax_number": "304-725-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD DIAZ, DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "304-725-4492",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0136653000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Anne Mary Rhoades, SLP
• Makenzie Faith Rhodes, PTA
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• Renee Roark
• Malachi K Roberson
• Maria Christine Roberts, LPN
• Pamela Roberts

• General Practice Dentistry in Charles Town, WV
• Providers in Charles Town, 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 Aug 22, 2020; 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.