Daniel Kelly Wilfong, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30022126 Issued in OH

Practice address

2905 Dudley Ave
Parkersburg, WV 26101

Phone

(304) 424-5002

Fax

(304) 422-5740

NPI assigned

Nov 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 26, 2015 through May 26, 2027

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.

• Erica Bailey, DDS and Chad Bush, DDS, PLLC

  • Dental Clinic/Center
  • Parkersburg, WV
  • NPI 1770045411
  NPD (past)
• Mark a. Delli-Gatti, D.D.S. & Associates

  • General Practice Dentistry
  • Parkersburg, WV
  • NPI 1982881777
  NPD (past)

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196121600000",
    "number": "1770765257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 DUDLEY AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "26101",
            "telephone_number": "304-424-5002",
            "fax_number": "304-422-5740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 DUDLEY AVE",
            "city": "PARKERSBURG",
            "state": "WV",
            "postal_code": "26101",
            "telephone_number": "304-424-5002",
            "fax_number": "304-422-5740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILFONG",
        "first_name": "DANIEL",
        "middle_name": "KELLY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-27",
        "last_updated": "2007-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30022126",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "3699",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Louise Wigal
• Sophia H Wigal
• Whitney N Wigal, PA-C
• Sarah Beth Wiggins, CARE COORDINATOR
• Paula Josephine Wildi, MS, CCC-SLP
• Stephanie Wilks, P.R.S.S
• Shelly E. Willham, CFNP
• Ashley B Willhoite
• William M. Bauer
• Andrew Williams

• Dentist in Parkersburg, WV
• Providers in Parkersburg, WV by specialty
• Dentist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.