DRS. LACY & WEIDMAN, PLLC (NPI# 1356560346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356560346 |
| Entity Type | Organization |
| Organization Name | DRS. LACY & WEIDMAN, PLLC |
| Other Organization Name | DRS. LACY, WEIDMAN & HAZEY III |
| Practice Address |
112 Hill St Bridgeport WV 26330-1756 |
| Practice Telephone | 3048425211 |
| Practice Fax Number | 3048421163 |
| Mailing Telephone | 3048425211 |
| Mailing Fax Number | 3048421163 |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GREGORY A LACY (OWNER) |
| Authorized Official Telephone | 3048425211 |
| Authorized Official Credential | D.D.S., M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
2285 | WV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | NPI NUMBER | 177-065-0012 | 01 |
| WV | NPI NUMBER | 163-924-6887 | 01 |
| WV | NPI NUMBER | 165-944-8991 | 01 |
| Other Name | Type Code |
|---|---|
| Drs. Lacy, Weidman & Hazey III | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568682870 | Drs. Lacy & Weidman, Pllc | Dentist | 918 Chestnut Ridge Prof. Bldg., Suite #5, Morgantown, WV 26505-2822 | 2007-04-27 |
| Street Address |
112 HILL ST |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-1756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303036 | Gage Mackenzie Chichester | Nurse Anesthetist, Certified Registered | 2673 Medical Park Drive, Bridgeport, WV 26330 | 2020-10-12 |
| 1851914105 | Melany Langhurst | Social Worker | 64 Professional Place, Suite 102, Bridgeport, WV 26330 | 2020-05-21 |
| 1245704980 | Adam Christopher Stonestreet | Social Worker | Community Care of Bridgeport, 65 Professional Place, Bridgeport, WV 26330 | 2019-01-16 |
| 1588146658 | Bridgeport Physical Therapy Services, Inc. | Occupational Therapist | 25 Sweetbrier Lane, Suite 105, Bridgeport, WV 26330 | 2018-09-05 |
| 1275040685 | White Oaks Assisted Living | Assisted Living Facility | 140 Professional Place White Oaks, Bridgeport, WV 26330 | 2018-01-08 |
| 1275049371 | Regional Eye Associates, Inc | Ophthalmology | 220 Southview Drive, Bridgeport, WV 26330 | 2017-12-27 |
| 1528586187 | Savanna Tamia Brown | Social Worker | 65 Professinal Place Suites 101,102103, Bridgeport, WV 26330 | 2017-09-05 |
| 1184079642 | Karla Kay Rinehart | Social Worker | 27 Trovato St., Suite 103, Bridgeport, WV 26330 | 2016-05-03 |
| 1396176756 | Willo Group LLC | Pharmacy | 460 E. Main Street, Bridgeport, WV 26330 | 2013-12-10 |
| 1891031878 | Sherri Michelle Dobson | Occupational Therapy Assistant | 1000 Maplewood Dr, Bridgeport, WV 26330 | 2012-12-20 |
| Find all providers in zip 26330 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750696399 | Connecticut Family Dental, Inc | Dentist | 3885 Main St, Suite 101, Bridgeport, CT 06606-2814 | 2010-08-06 |
| 1922271550 | Shyam Desai | Dentist | 3741 Main St, Bridgeport, CT 06606-3609 | 2008-04-03 |
| 1184605974 | Michael B Montanaro | Dentist | 5294 Park Ave, Bridgeport, CT 06604-1018 | 2005-11-08 |
| 1316571425 | Myorthos Connecticut Orthodontics PC | Dentist | 3909 Main St, Bridgeport, CT 06606-2872 | 2020-02-27 |
| 1184258386 | Myorthos Holdings, LLC | Dentist | 3909 Main St, Bridgeport, CT 06606-2872 | 2020-02-26 |
| 1700378916 | Arthur Kim | Dentist | 2690 E Main St, Bridgeport, CT 06610-1422 | 2018-06-04 |
| 1881048080 | Bridgeport Braces, LLC | Dentist | 3715 Main St, Suite 100, Bridgeport, CT 06606-3618 | 2016-04-14 |
| 1588048748 | Ct Braces Bridgeport Orthodontics PC | Dentist | 3909 Main St, Suite A, Bridgeport, CT 06606-2872 | 2015-07-16 |
| 1467886614 | Ismile Orthodonticsof LLC | Dentist | 2417 E Main St, Bridgeport, CT 06610-1802 | 2013-08-23 |
| 1679849186 | Andrew Thompson | Dentist | 930 W Main St, Bridgeport, WV 26330-1673 | 2012-03-29 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 26330 |
Please comment or provide details below to improve the information on DRS. LACY & WEIDMAN, PLLC.
| 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.