DR. KRYSTIN BOURDUA AUSTIN (NPI# 1407385735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407385735 |
| Entity Type | Individual |
| Full Name | DR. KRYSTIN BOURDUA AUSTIN |
| Other Name | KRYSTIN BOURDUA |
| Credential | DDS |
| Practice Address |
3997 Beckley Rd Princeton WV 24740-7660 |
| Practice Telephone | 3044254585 |
| Practice Fax Number | 3044313400 |
| Mailing Telephone | 3044315499 |
| Mailing Fax Number | 3044312661 |
| Enumeration Date | 2017-06-09 |
| Last Update Date | 2019-01-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
4265 | WV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 1407385735 | 05 |
| Street Address |
3997 BECKLEY RD |
| City | PRINCETON |
| State | WV |
| Zip Code | 24740-7660 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033108733 | William Claude Bird | Family Medicine | 3997 Beckley Rd, Bluestone Health Assoc, Princeton, WV 24740 | 2005-10-17 |
| 1972120459 | Amanda Nicole Meadows | Nurse Practitioner | 3997 Beckley Rd, Princeton, WV 24740-7660 | 2020-06-30 |
| 1386297901 | Heather Waddell | Nurse Practitioner | 3997 Beckley Rd, Princeton, WV 24740-7660 | 2019-07-23 |
| 1326527870 | Jessica Ann Deel | Nurse Practitioner | 3997 Beckley Rd, Princeton, WV 24740-7660 | 2018-08-07 |
| 1497240774 | Angela Michelle Akers | Nurse Practitioner | 3997 Beckley Rd, Princeton, WV 24740-7660 | 2018-06-28 |
| 1972097103 | Melissa Bogle | Nurse Practitioner | 3997 Beckley Rd, Princeton, WV 24740-7660 | 2018-06-20 |
| 1497249734 | Amy K Adams | Nurse Practitioner | 3997 Beckley Rd, Princeton, WV 24740-7660 | 2018-06-20 |
| 1548617186 | Heather Lee Green | Nurse Practitioner | 3997 Beckley Rd, Princeton, WV 24740-7660 | 2016-05-23 |
| 1891171401 | Tracy Mckenzie | Registered Nurse | 3997 Beckley Rd, Princeton, WV 24740-7660 | 2015-08-05 |
| 1003299116 | Leigh Brooks | Nurse Practitioner | 3997 Beckley Rd, Princeton, WV 24740-7660 | 2015-07-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658632 | New Beginnings Therapy Services, LLC | Community/Behavioral Health | 616 Harrison Street, Princeton, WV 24740 | 2020-10-27 |
| 1215536222 | Right At Home | Home Health | 313 Locus St, Princeton, WV 24740 | 2020-10-21 |
| 1881208098 | Robin Lane | Technician | 174 Tea Kettle Road, Princeton, WV 24740 | 2020-09-04 |
| 1134739824 | Nona Arthur | Technician | 708 Bluefiled Ave, Princeton, WV 24740 | 2020-08-06 |
| 1851909014 | Tina B Altizer | Speech-Language Pathologist | 120 12th Street, Princeton, WV 24740 | 2020-07-14 |
| 1245712504 | Tracy Jean Mitchell | Speech-Language Pathologist | 1200 Mercer St, Princeton, WV 24740 | 2018-09-04 |
| 1700305240 | Tina Six | Registered Nurse | 1403 Honaker Avenue, Princeton, WV 24740 | 2017-09-15 |
| 1013449172 | Karin Cappa | Pharmacist | 669 Cornfield Rd, Princeton, WV 24740 | 2017-03-29 |
| 1942661723 | Virginia Chryssikos | Social Worker | 3016 E Cumberland Road, Bluestone Family Practice, Bluefield, WV 24740 | 2016-03-08 |
| 1477939460 | Kathy Diane Wyrick | Counselor | 220 South Walker Street, Princeton, WV 24740 | 2015-08-03 |
| Find all providers in zip 24740 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528611944 | Cecilia Amarantha White | Dentist | 601 Ewing St Ste B16, Princeton, NJ 08540-2755 | 2019-07-24 |
| 1992008932 | Jody Annette Gill | Dentist | 670 W Princeton Dr Ste 600, Princeton, TX 75407-2556 | 2010-12-14 |
| 1790098630 | Guojun Ma | Dentist | 10 Harrogate Cir, Princeton, NJ 08540-7942 | 2010-07-20 |
| 1255595096 | Princeton Family Dental | Dentist | 275 W Princeton Dr, # 100, Princeton, TX 75407-9602 | 2008-07-10 |
| 1477724409 | Philip J. Lingle | Dentist | 510 1st St, Princeton, MN 55371-1604 | 2008-03-18 |
| 1760652424 | Hubert H Byron Jr. | Dentist | 202 S Walker St, Princeton, WV 24740-2747 | 2008-03-09 |
| 1689877664 | Peter M Lewis | Dentist | 253 Witherspoon St Ste 253, Princeton, NJ 08540-3211 | 2007-06-07 |
| 1467654434 | I. Andrew Shelpuk | Dentist | 364 Nassau St, Princeton, NJ 08540-4615 | 2007-06-01 |
| 1174724868 | Poorva Parnaik | Dentist | 5 Aldgate Ct, Princeton, NJ 08540-7014 | 2007-05-30 |
| 1225239403 | Elite Dental Care Inc | Dentist | 838 Alexander Rd, Princeton, NJ 08540-6304 | 2007-05-29 |
| Find all providers in PRINCETON | ||||
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| 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.