BRUCE L CASSIS (NPI# 1679664510) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679664510 |
| Entity Type | Individual |
| Full Name | BRUCE L CASSIS |
| Credential | D.D.S. |
| Practice Address |
138 Lively St Fayetteville WV 25840-1148 |
| Mailing Address |
Po Box 926 Fayetteville WV 25840-0926 |
| Practice Telephone | 3045740424 |
| Practice Fax Number | 3045742102 |
| Mailing Telephone | 3045740424 |
| Mailing Fax Number | 3045742102 |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
WV2530 | WV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WV | 0136422000 | 05 |
| Street Address |
138 LIVELY ST |
| City | FAYETTEVILLE |
| State | WV |
| Zip Code | 25840-1148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619339207 | Cassis Dental Center, Pllc | Dentist | 138 Lively St, Fayetteville, WV 25840-1148 | 2016-03-23 |
| 1386964948 | Daniel Joseph Cassis | Dentist | 138 Lively St, Fayetteville, WV 25840-1148 | 2010-06-07 |
| 1275718710 | Bruce L. Cassis | Dentist | 138 Lively St, Fayetteville, WV 25840-1148 | 2008-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447766639 | Nancy Carol Myles | Technician | 171 Wood Rd, Fayetteville, WV 25840 | 2017-12-26 |
| 1598933954 | Kembra Anne Crist | Registered Nurse | 111 Fayette Avenue, Fayette County Boe, Fayetteville, WV 25840 | 2008-02-19 |
| 1003004854 | Edward Lee Winter | Psychologist | 111 Fayette Ave., Fayette County Schools, Fayetteville, WV 25840 | 2007-10-05 |
| 1811109432 | Anita Louise Swanson | Physical Therapist | 111 Fayette Ave, Fayetteville, WV 25840 | 2007-05-04 |
| 1003964008 | Krista L Copenhaver-mackowiak | Nurse Anesthetist, Certified Registered | 613 Crooked Run Rd, Fayetteville, WV 25840 | 2007-01-08 |
| 1922171024 | Carl Arthur Hansen | Dentist | 215 North Court St, Fayetteville, WV 25840 | 2006-11-16 |
| 1932202447 | Appalachian Regional Healthcare | Clinic/Center | 436 Elizabeth Way, Fayetteville, WV 25840 | 2006-09-07 |
| 1154424810 | West Virginia Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 72 Whitewater Ave, Fayetteville, WV 25840 | 2006-09-07 |
| 1447241310 | Karen L. Pettry-hultman | Family Medicine | Rr 3 Box 9, Fayetteville, WV 25840 | 2005-10-31 |
| 1598125577 | Jeanne Black | Registered Nurse | 111 Fayette Avenue, Fayette County Schools, Fayetteville, WV 25840 | 2016-03-03 |
| Find all providers in zip 25840 | ||||
| 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 |
|---|---|---|---|---|
| 1346898335 | Chaitanya Joopally Dds Pllc | Dentist | 2050 Skibo Rd. Ste 104, Fayetteville, NC 28314 | 2019-09-03 |
| 1972151439 | Ikenna K Okons | Dentist | 4200 Morganton Rd Ste 304, Fayetteville, NC 28314-1564 | 2019-08-28 |
| 1114488079 | Bianca Kristina Adams | Dentist | 207 Forest Creek Dr, Fayetteville, NC 28303-5496 | 2019-03-25 |
| 1194226506 | Michael E. Carter, Dds, Pllc | Dentist | 1874 N Hunters Rdg Ste 1, Fayetteville, AR 72701-2896 | 2018-02-22 |
| 1760900153 | Elali Alisha Marie Moukwa | Dentist | 1916 Skibo Rd Ste C3, Fayetteville, NC 28314 | 2017-09-06 |
| 1548781107 | Christopher Heard | Dentist | 265 N Jeff Davis Dr Ste 1a, Fayetteville, GA 30214-1668 | 2017-07-03 |
| 1881123305 | Kenneth Boyd Lewis Jr. | Dentist | 4140 Ramsey St Ste 104, Fayetteville, NC 28311-7658 | 2017-06-08 |
| 1518496215 | Van Michael Mcqueen Jr. | Dentist | 640 N Garland Ave # 104, Fayetteville, AR 72701 | 2017-06-06 |
| 1710415229 | Alan Kuo | Dentist | 1400 Walter Reed Rd Ste 200, Fayetteville, NC 28304 | 2017-05-28 |
| 1508304866 | Karan G Mirchandani | Dentist | 4251 Ramsey St Ste 8, Fayetteville, NC 28311-2130 | 2017-02-07 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 25840 |
Please comment or provide details below to improve the information on BRUCE L CASSIS.
| 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.