Active NPI
Lauren Srivastava
- Public Health Dentistry
- Morgantown, WV
National Provider Identifier
1811675952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health Dentistry
- License
- 4643
- Practice address
- 250 Tide Way
Morgantown, WV 26508-1800 - Phone
- (484) 802-7238
- NPI assigned
- Jul 10, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 4643 | WV | Primary |
Addresses
Primary practice location
250 Tide Way
Morgantown, WV 26508-1800
Mailing address
250 Tide Way
Morgantown, WV 26508-1800
Phone (484) 802-7238
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4643 | WV | MD | Public Health Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1688947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1811675952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "250 TIDE WAY",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265081800",
"telephone_number": "484-802-7238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 TIDE WAY",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265081800",
"telephone_number": "484-802-7238"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SRIVASTAVA",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-10",
"last_updated": "2023-07-10",
"certification_date": "2023-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "WV",
"license": "4643",
"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 Jul 10, 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.