Michael Medovic, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2513 Issued in WV

Practice address

53 14TH St
Suite 102
Wheeling, WV 26003-3433

Phone

(304) 232-2140

Fax

(304) 232-4760

NPI assigned

Jul 24, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972525434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 14TH ST",
            "address_2": "SUITE 102",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033433",
            "telephone_number": "304-232-2140",
            "fax_number": "304-232-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 14TH ST",
            "address_2": "SUITE 102",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260033433",
            "telephone_number": "304-232-2140",
            "fax_number": "304-232-4760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDOVIC",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "2513",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Med-Care Transportation North, LLC
• Medexpress Urgent Care, PLLC - Wheeling
• Azedine Medhkour, M.D.
• Medical Park Anesthesiologists, Inc.
• Medical Rehabilitative Services
• Sunila Mehrotra, M.D. F.A.A.P.
• Allyson Brooke Melching
• Jason Melegari, RN
• Chance Mellinger
• Lauryn Menges, PA-C

• General Practice Dentistry in Wheeling, WV
• Providers in Wheeling, 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 Jul 8, 2007; 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.