Ian Montgomery Weaver, DDS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

10909 Issued in KY

Practice address

451 Suncrest Town Centre Dr
Morgantown, WV 26505-1814

Phone

(304) 541-2284

NPI assigned

Oct 13, 2021

Last updated

May 9, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Weaver Orthodontics PLLC

  • Dental Clinic/Center
  • Corbin, KY
  • NPI 1851100127
  NPD Authorized official

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1801558150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 CHERRY WOOD DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265084237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 SUNCREST TOWN CENTRE DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265051814",
            "telephone_number": "304-541-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "IAN",
        "middle_name": "MONTGOMERY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-13",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "KY",
            "license": "10909",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WV",
            "license": "4468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenadee Shea Wayt, PA-C
• Barbara Weaner, CFNP
• Carly Wears, MSW
• Christy Weatherly
• Bryan Douglas Weaver, DDS,MD
• Melinda Weaver, MNT
• Samantha Elizabeth Weaver
• Emily Kathleen Webb
• Allison Weber
• David C Webster, PAC

• Orthodontics and Dentofacial Orthopedics Dentistry in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2023; 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.