NPIMap

Organization Active NPI

Kimberly T. Lough, DDS, Ms, PLLC

  • Pediatric Dentistry
  • St Albans, WV
National Provider Identifier
1992905129
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
3415 Issued in WV
Legal business name
KIMBERLY T. LOUGH, DDS, MS, PLLC
Practice address
12 Kanawha Ter
Suite B
St Albans, WV 25177
Phone
(304) 722-7221
Fax
(304) 722-0420
NPI assigned
Jul 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Authorized official

Name
Dr. Kimberly T Lough, DDS, MSNPI 1326001801
Title
Pediatric Dentist / Owner
Phone
(304) 722-7221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 3415 WV Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 3783 WV

Addresses

Primary practice location

12 Kanawha Ter
Suite B
St Albans, WV 25177

Mailing address

12 Kanawha Terrace
Suite B
St Albans, WV 25177
Phone (304) 722-7221

Other identifiers 1

IdentifierTypeStateIssuer
4004039000MedicaidWV

National Provider Directory

National Provider Directory

Locations

12 Kanawha Ter
#B
Saint Albans, WV 25177
Phone (304) 722-7221

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1992905129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 KANAWHA TERRACE",
            "address_2": "SUITE B",
            "city": "ST ALBANS",
            "state": "WV",
            "postal_code": "25177",
            "telephone_number": "304-722-7221",
            "fax_number": "304-722-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 KANAWHA TER",
            "address_2": "SUITE B",
            "city": "ST ALBANS",
            "state": "WV",
            "postal_code": "25177",
            "telephone_number": "304-722-7221",
            "fax_number": "304-722-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBERLY T. LOUGH, DDS, MS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "LOUGH",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST / OWNER",
        "authorized_official_telephone_number": "304-722-7221",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WV",
            "license": "3415",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WV",
            "license": "3783",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4004039000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Albans, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.