APPALACHIAN ORAL SURGERY CENTER (NPI# 1104359959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104359959 |
| Entity Type | Organization |
| Organization Name | APPALACHIAN ORAL SURGERY CENTER |
| Practice Address |
3433 University Ave Suite 1 Morgantown WV 26505-3052 |
| Practice Telephone | 3043224532 |
| Mailing Telephone | 3043224532 |
| Enumeration Date | 2017-04-09 |
| Last Update Date | 2017-04-09 |
| Authorized Official Name | DR. MATTHEW ELWOOD KOEPKE (MEMBER) |
| Authorized Official Telephone | 3049047145 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
4011 | WV | Dental Providers |
| Street Address |
3433 UNIVERSITY AVE SUITE 1 |
| City | MORGANTOWN |
| State | WV |
| Zip Code | 26505-3052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535208 | Robert Howard Taylor | Pharmacist | 1608 Earl Core Rd, Morgantown, WV 26505 | 2020-10-13 |
| 1194366757 | Grace Catherine Clonch | Student in an Organized Health Care Education/Training Program | 3450 Monogahela Blvd, Morgantown, WV 26505 | 2019-10-04 |
| 1538629852 | Alexander Gross | Student in an Organized Health Care Education/Training Program | : 64 Medical Center Drive, Room 4601, Morgantown, WV 26505 | 2019-03-22 |
| 1194284018 | Ana Isabel Gomez Velazquez | Student in an Organized Health Care Education/Training Program | 64 Medical Center Dr., Room 4601, Morgantown, WV 26505 | 2019-03-19 |
| 1922584242 | Lisa Kate Hostutler | Pharmacist | 1851 Earl L. Core Rd, Morgantown, WV 26505 | 2018-07-19 |
| 1760983779 | Ashley Garner | Social Worker | 3602 Collins Ferry Road, Morgantown, WV 26505 | 2018-02-24 |
| 1861992174 | Usa Vein Clinics of West Virginia Pllc | Surgery | 1010 Suncrest Towne Centre, Morgantown, WV 26505 | 2018-02-14 |
| 1396272092 | Essential Foundations, Pllc | Community/Behavioral Health | 1287 Suncrest Towne Centre, Morgantown, WV 26505 | 2017-05-12 |
| 1689111452 | Good Heart Therapy Services, Pllc | Public Health or Welfare | 235 Hgh Street, Suite 311, Morgantown, WV 26505 | 2017-01-31 |
| 1982141776 | Heidi Otoole | Counselor | 235 High Street, Suite 720, Morgantown, WV 26505 | 2017-01-31 |
| Find all providers in zip 26505 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194255620 | William Black | Dentist | Room 1200 Hsc North, P.o. Box 9475, Morgantown, WV 26506 | 2017-06-18 |
| 1023318201 | James G Bryant Dmd | Dentist | 5000 Hampton Ctr Ste 1, Morgantown, WV 26505-1709 | 2010-10-22 |
| 1164646725 | William A. Myers II Dmd Ltd | Dentist | 1191 Pineview Dr Ste D, Morgantown, WV 26505-2778 | 2007-04-12 |
| 1326122797 | James Gregory Bryant | Dentist | 5000 Hampton Center, Suite 1, Morgantown, WV 26505 | 2006-10-24 |
| 1437184496 | Thaddus Rusiecki | Dentist | 2602 Cranberry Square, Morgantown, WV 26505 | 2006-07-11 |
| 1750589362 | Matthew Comiskey | Dentist | 1 Medical Center Dr, West Virginia University, Morgantown, WV 26506-9475 | 2007-07-05 |
| 1992921092 | Thad Rusiecki, Dds, Pllc | Dentist | 2602 Cranberry Square, Morgantown, WV 26505 | 2007-04-17 |
| 1811032071 | John Montgomery Carson | Dentist | 2199 Cheat Rd, Morgantown, WV 26508-4451 | 2007-02-21 |
| 1598832941 | William Andrew Myer II | Dentist | 1191 Pineview Dr, Suite D, Morgantown, WV 26505-2778 | 2006-11-29 |
| 1124101670 | Gerald Edwin Nieusma | Dentist | 1 Med Center Drive, Morgantown, WV 26506 | 2006-10-20 |
| Find all providers in MORGANTOWN | ||||
| City | MORGANTOWN |
| Zip Code | 26505 |
Please comment or provide details below to improve the information on APPALACHIAN ORAL SURGERY CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.