Nadia Mardmomen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4533 Issued in WV

Practice address

9 Chenoweth Dr
Bridgeport, WV 26330-1885

Phone

(304) 842-1921

NPI assigned

May 10, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Country Club Dental PLLC

  • General Practice Dentistry
  • Fairmont, WV
  • NPI 1821959131
  NPD Authorized official
• Dentica Associates, LLC

  • Pediatric Dentistry
  • Canonsburg, PA
  • NPI 1750566246
  NPD (past)
• Dentica, Inc.

  • Pediatric Dentistry
  • Canonsburg, PA
  • NPI 1730364241
  NPD (past)

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1720662471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 WOODBROOK LN",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301047",
            "telephone_number": "304-672-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 CHENOWETH DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301885",
            "telephone_number": "304-842-1921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1219 Johnson Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "WV",
            "postal_code": "263301353",
            "country_code": "US",
            "telephone_number": "304-842-7591",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARDMOMEN",
        "first_name": "NADIA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy N Manning, DPT
• Ashley Nicole Mansberry
• Maplewood
• Maplewood SNF LLC (Mapelwood Rehabilitation & Healthcare Center)
• Megan Marchio
• Harry Marinakis, MD
• Salvatore Marino, PA-C
• Mark B. Vecchio, D.D.S.
• Claire Marnic
• Ashley Renee Marshall

• General Practice Dentistry in Bridgeport, WV
• Providers in Bridgeport, 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 Jun 29, 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.