NPIMap

Organization Active NPI

Samantha Jette DDS - Professional Corporation

  • General Practice Dentistry
  • Clarksburg, WV
National Provider Identifier
1902666415
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SAMANTHA JETTE DDS - PROFESSIONAL CORPORATION
Practice address
234 Court St
Clarksburg, WV 26301-2906
Phone
(304) 623-4984
Fax
(304) 623-2830
NPI assigned
Mar 21, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Authorized official

Name
Dr. Samantha Jette, DDSNPI 1700254034
Title
Owner
Phone
(304) 623-4984

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

234 Court St
Clarksburg, WV 26301-2906

Mailing address

234 Court St
Clarksburg, WV 26301-2906
Phone (304) 623-4984

Other names 1

  • Clarksburg Family Dentistry Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Bridgeport Family Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

234 Court St
Clarksburg, WV 26301
Phone (304) 623-4984

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710979200000",
    "number": "1902666415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 COURT ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012906",
            "telephone_number": "304-623-4984",
            "fax_number": "304-623-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 COURT ST",
            "city": "CLARKSBURG",
            "state": "WV",
            "postal_code": "263012906",
            "telephone_number": "304-623-4984",
            "fax_number": "304-623-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMANTHA JETTE DDS - PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A",
        "authorized_official_last_name": "JETTE",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-623-4984",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarksburg Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksburg, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.