Individual provider Active NPI

Maureena L Andreas, DDS

  • Dentist
  • Parsons, WV
National Provider Identifier
1780696757
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
WV2790 Issued in WV
Practice address
104 Kohler St
Parsons, WV 26287
Phone
(304) 478-4700
NPI assigned
Aug 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X WV2790 WV Primary

Addresses

Primary practice location

104 Kohler St
Parsons, WV 26287

Mailing address

104 Kohler St
Parsons, WV 26287
Phone (304) 478-4700

Other identifiers 1

IdentifierTypeStateIssuer
0132825000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150729009949 WV Order and Referring Only - DentistPractitioner - Dentist 4082928411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
WV2790WVMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780696757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 KOHLER ST",
            "city": "PARSONS",
            "state": "WV",
            "postal_code": "26287",
            "telephone_number": "304-478-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 KOHLER ST",
            "city": "PARSONS",
            "state": "WV",
            "postal_code": "26287",
            "telephone_number": "304-478-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREAS",
        "first_name": "MAUREENA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "WV2790",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0132825000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsons, WV

Sources for this page

Verify at the official NPI Registry.