Individual provider Active NPI

Frederick Sammons Jr., DDS MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Huntington, WV
National Provider Identifier
1912374075
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2332 Issued in WV
Practice address
1040 20TH St
Huntington, WV 25703-2059
Phone
(304) 522-3512
Fax
(304) 522-6233
NPI assigned
Aug 25, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 2332 WV Primary

Addresses

Primary practice location

1040 20TH St
Huntington, WV 25703-2059

Mailing address

1040 20TH St
Huntington, WV 25703-2059
Phone (304) 522-3512

Other identifiers 1

IdentifierTypeStateIssuer
0137863000MedicaidWV

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Frederick H Sammons DDS LTD Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440460800000",
    "number": "1912374075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 20TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257032059",
            "telephone_number": "304-522-3512",
            "fax_number": "304-522-6233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 20TH ST",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257032059",
            "telephone_number": "304-522-3512",
            "fax_number": "304-522-6233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMMONS",
        "first_name": "FREDERICK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2015-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WV",
            "license": "2332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137863000",
            "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 Aug 25, 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.