Active NPI
Angela Douglas, DDS
- Dentist
- Shady Spring, WV
National Provider Identifier
1952837700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4305
- Practice address
- 479 Flat Top Rd
Shady Spring, WV 25918-8614 - Phone
- (304) 763-4665
- NPI assigned
- May 11, 2017
- Last updated
- May 11, 2020
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 4305 | WV | Primary |
Addresses
Primary practice location
479 Flat Top Rd
Shady Spring, WV 25918-8614
Mailing address
479 Flat Top Rd
Shady Spring, WV 25918-8614
Phone (304) 763-4665
Other practice location 1
1 Physicians Plaza
Lochgelly, WV 25866
Phone (304) 469-4911
Other practice location 2
1616 13th Ave
Huntington, WV 25701-3840
Phone (304) 691-6973
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 |
|---|---|---|---|
| 4305 | WV | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clay and Hiener Dentistry Partnership | Dentist | Past | Accepting new patients |
| C Jeff Clay, D.D.S. Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Shady Spring, WV
- NPI 1982765517
-
dba Shady Spring Dental Care
- Dentist
- Shady Spring, WV
- NPI 1598903973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494460800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589155200000",
"number": "1952837700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "479 FLAT TOP RD",
"city": "SHADY SPRING",
"state": "WV",
"postal_code": "259188614",
"telephone_number": "304-763-4665"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "479 FLAT TOP RD",
"city": "SHADY SPRING",
"state": "WV",
"postal_code": "259188614",
"telephone_number": "304-763-4665"
}
],
"practiceLocations": [
{
"address_1": "1 Physicians Plaza",
"address_purpose": "LOCATION",
"city": "Lochgelly",
"state": "WV",
"postal_code": "25866",
"country_code": "US",
"telephone_number": "304-469-4911",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1616 13th Ave",
"address_purpose": "LOCATION",
"city": "Huntington",
"state": "WV",
"postal_code": "257013840",
"country_code": "US",
"telephone_number": "304-691-6973",
"fax_number": "304-691-1248",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DOUGLAS",
"first_name": "ANGELA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-11",
"last_updated": "2020-05-11",
"certification_date": "2020-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "4305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shady Spring, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.