Daren Wadsworth, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4458 Issued in WV

Practice address

111 S Grove St Ste 1
Petersburg, WV 26847-1805

Phone

(304) 257-4593

NPI assigned

Jul 7, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rainelle Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Meadow Bridge, WV
  • NPI 1093883324
  Medicare reassignment NPD
• Rainelle Medical Center Inc

  • Federally Qualified Health Center (FQHC)
  • Rainelle, WV
  • NPI 1437227766
  NPD
• Rainelle Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Caldwell, WV
  • NPI 1578399085
  NPD

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

{
    "created_epoch": "1594080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1932727971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97",
            "city": "BAKER",
            "state": "WV",
            "postal_code": "268010097",
            "telephone_number": "304-897-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S GROVE ST STE 1",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268471805",
            "telephone_number": "304-257-4593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Shaner Dr Ste 108",
            "address_purpose": "LOCATION",
            "city": "Bridgeport",
            "state": "WV",
            "postal_code": "263302626",
            "country_code": "US",
            "telephone_number": "304-694-7496",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WADSWORTH",
        "first_name": "DAREN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-07",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "4458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Veach
• Justin Neil Venable, MD
• Kathryn Verzich
• Kimberly Vint
• Jamie Vuono
• Josephine Margaret Wagoner, RPH
• Walgreen Co
• Breeona Walker
• Lori Walker
• Chelsie Walls

• General Practice Dentistry in Petersburg, WV
• Providers in Petersburg, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.