Active NPI
Andrew Michael Marra, DDS
- Endodontics
- Morgantown, WV
National Provider Identifier
1972163558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 4416
- Practice address
- 9000 Coombs Farm Rd Ste 304
Morgantown, WV 26508-1150 - Phone
- (304) 594-1670
- NPI assigned
- Jun 17, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4416 | WV | |
| General Practice Dentistry | 1223G0001X | 18847 | MD | |
| Endodontics | 1223E0200X | 4416 | WV | Primary |
| Dentist | 122300000X | DS045298 | PA |
Addresses
Primary practice location
9000 Coombs Farm Rd Ste 304
Morgantown, WV 26508-1150
Mailing address
3708 Sun PL
Morgantown, WV 26505-1149
Phone (304) 290-9752
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 |
|---|---|---|---|
| 18847 | MD | MD | Clinical Social Worker |
| DS045298 | PA | MD | Dentist |
| 4416 | WV | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. K. Paul Wilson, PLLC | General Practice | Past | Accepting new patients |
| Jeffrey G. Minchau, DDS, Ms, Inc. | Endodontics | Past | Accepting new patients |
| Morgantown Dental, PLLC | Endodontics | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Endodontics
- Parkersburg, WV
- NPI 1871085787
-
- Endodontics
- Morgantown, WV
- NPI 1992297733
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755561600000",
"number": "1972163558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3708 SUN PL",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265051149",
"telephone_number": "304-290-9752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 COOMBS FARM RD STE 304",
"city": "MORGANTOWN",
"state": "WV",
"postal_code": "265081150",
"telephone_number": "304-594-1670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARRA",
"first_name": "ANDREW",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-17",
"last_updated": "2025-08-19",
"certification_date": "2025-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WV",
"license": "4416",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "18847",
"primary": false
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "WV",
"license": "4416",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS045298",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morgantown, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.