Skylar Kipps, DDS

Individual provider Active NPI General Practice Dentistry · Shady Spring, WV

NPI 1780359752 · NPPES record last updated Aug 12, 2021

Key facts

NPI
1780359752
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4537 (WV)
Practice address
479 Flat Top Rd
Shady Spring, WV 25918-8614
Phone
(304) 763-4665
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4537WVMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Clay and Hiener Dentistry Partnership Past
since Aug 15, 2021
Accepting new patients
C Jeff Clay, D.D.S. Inc. General Practice Past
since Aug 15, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4537 WV Yes

Addresses

Primary practice location

479 Flat Top Rd
Shady Spring, WV 25918-8614

Mailing address

479 Flat Top Rd
Shady Spring, WV 25918-8614
Phone (304) 763-4665

Other practice location 1

1 Physicians Plaza
Lochgelly, WV 25866
Phone (304) 469-4911

Other providers in Shady Spring, WV

All providers in Shady Spring, WV · General Practice Dentistry in West Virginia

Sources for this page

Verify at the official NPI Registry.