Active NPI
Scott Edmonds, D.D.S.
- General Practice Dentistry
- Huntington, WV
National Provider Identifier
1902906761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 3634
- Practice address
- 5187 Route 60 East
10
Huntington, WV 25705 - Phone
- (304) 736-3422
- Fax
- (304) 736-2390
- NPI assigned
- Sep 22, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 3634 | WV | Primary |
Addresses
Primary practice location
5187 Route 60 East
10
Huntington, WV 25705
Mailing address
5354 Camp Road
Lavalette, WV 25535
Phone (304) 617-5454
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3810002278 | Medicaid | WV |
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 |
|---|---|---|---|
| 3634 | WV | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306195200000",
"number": "1902906761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5354 CAMP ROAD",
"city": "LAVALETTE",
"state": "WV",
"postal_code": "25535",
"telephone_number": "304-617-5454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5187 ROUTE 60 EAST",
"address_2": "10",
"city": "HUNTINGTON",
"state": "WV",
"postal_code": "25705",
"telephone_number": "304-736-3422",
"fax_number": "304-736-2390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EDMONDS",
"first_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-22",
"last_updated": "2011-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WV",
"license": "3634",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3810002278",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Huntington, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.