BRUCETON DENTAL PLLC NPI 1215385935

NPI Information

  • NPI: 1215385935
  • Provider Name: BRUCETON DENTAL PLLC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • CLIA Number: 51D2178876
  • Address: 128 GREEN STREET
    BRUCETON MILLS, WV
    ZIP 26525
  • Phone: (304) 379-8101

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NPI Details

BRUCETON DENTAL PLLC is a dental clinic center in Bruceton Mills, WV. BRUCETON DENTAL PLLC NPI is 1215385935. The provider is registered as an organization entity type.

The provider's business location address is:

128 GREEN STREET
BRUCETON MILLS, WV
ZIP 26525
Phone: (304) 379-8101
Fax: (304) 379-8102

The provider's authorized official is Scott Reo Okubo .
The authorized official title is Dds/owner and has the following contact phone number (304) 379-8101.

The CLIA number assigned to this NPI record is 51D2178876 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/3/2016 and was last updated on 6/3/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDentalWV2976WEST VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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