NPIMap

Organization Active NPI

West Virginia University

  • Oral and Maxillofacial Pathology Dentistry
  • Morgantown, WV
National Provider Identifier
1801283874
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
4076 Issued in WV
Legal business name
WEST VIRGINIA UNIVERSITY
Practice address
1 Medical Center Drive
Oral Surgery Department
Morgantown, WV 26506
Phone
(304) 293-1127
Fax
(304) 293-3674
NPI assigned
Apr 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Authorized official

Name
Dr. Ashley Nicole Clark, DDS
Title
Assistant Professor
Phone
(304) 293-1127

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0106X 4076 WV Primary

Addresses

Primary practice location

1 Medical Center Drive
Oral Surgery Department
Morgantown, WV 26506

Mailing address

PO Box 9475
1 Medical Center Drive
Morgantown, WV 26506
Phone (304) 293-1127

National Provider Directory

National Provider Directory
Tax ID family
West Virginia University5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429228800000",
    "number": "1801283874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9475",
            "address_2": "1 MEDICAL CENTER DRIVE",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-293-1127",
            "fax_number": "304-293-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DRIVE",
            "address_2": "ORAL SURGERY DEPARTMENT",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "26506",
            "telephone_number": "304-293-1127",
            "fax_number": "304-293-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST VIRGINIA UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-17",
        "last_updated": "2015-04-17",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "ASSISTANT PROFESSOR",
        "authorized_official_telephone_number": "304-293-1127",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "WV",
            "license": "4076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; 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.