Joseph Gatens Vaughan, DDS, INC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3268 Issued in WV

Practice address

130 Cedar Knoll Dr
Ronceverte, WV 24970-8446

Phone

(304) 645-3333

Fax

(304) 647-5932

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Lakeview Sleep Solutions LLC

  • Customized Equipment (DME)
  • Ronceverte, WV
  • NPI 1699588525
  NPD
• Dr Joseph G Vaughan DDS Inc.

  • Dental Clinic/Center
  • Ronceverte, WV
  • NPI 1225149362
  NPD (past)

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1972523678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 CEDAR KNOLL DR",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708446",
            "telephone_number": "304-645-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 CEDAR KNOLL DR",
            "city": "RONCEVERTE",
            "state": "WV",
            "postal_code": "249708446",
            "telephone_number": "304-645-3333",
            "fax_number": "304-647-5932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAUGHAN",
        "first_name": "JOSEPH",
        "middle_name": "GATENS",
        "credential": "DDS, INC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "3268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0134332000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS ID NUMBER",
            "identifier": "000804538",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA ID NUMBE",
            "identifier": "804538",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda M Totten, ATC, PT, DPT
• True Choice Services
• Brenda Turner
• Valley Imaging Consultants Inc.
• Jamie Louise Vance, D.O.
• Paul T Vaughn, PAC
• Steven Vess, DO
• Casey Jolene Vest, COTA/L
• Walgreen Co
• Charles Walker

• General Practice Dentistry in Ronceverte, WV
• Providers in Ronceverte, 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 May 16, 2024; 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.