DR. AMANDA SARA BOUSTANY (NPI# 1710327556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710327556 |
| Entity Type | Individual |
| Full Name | DR. AMANDA SARA BOUSTANY |
| Credential | D.D.S., M.S.D. |
| Practice Address |
405 Capitol St Suite 914 Charleston WV 25301-1749 |
| Practice Telephone | 3043451248 |
| Practice Fax Number | 3043451249 |
| Mailing Telephone | 3043451248 |
| Mailing Fax Number | 3043451249 |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2017-01-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
4180 | WV | Dental Providers |
| Street Address |
405 CAPITOL ST SUITE 914 |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25301-1749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760406565 | John K Kuyk | Dentist | 405 Capitol St, Suite 914, Charleston, WV 25301-1749 | 2006-07-26 |
| 1518330463 | Capitol Endodontics, Pllc | Dentist | 405 Capitol St, Suite 914, Charleston, WV 25301-1749 | 2015-11-01 |
| 1235484502 | Madigan Rae Burgess | Dentist | 405 Capitol St, The Parlor Suite, Charleston, WV 25301-1749 | 2012-07-23 |
| 1508145921 | First Choice Health, Inc. | In Home Supportive Care | 405 Capitol St, Suite 1003, Charleston, WV 25301-1749 | 2011-08-16 |
| 1568470680 | John P Burgess | Dentist | 405 Capitol St, The Parlor Suite, Charleston, WV 25301-1749 | 2006-08-04 |
| 1134137904 | Elizabeth Michelle Fizer | Counselor | 405 Capitol St, Charleston, WV 25301-1749 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087680 | Kerrie Rena Harris | Counselor | 16 Leon Sullivan Way Suite 300, Charleston, WV 25301 | 2020-09-15 |
| 1285123471 | Burgess Dental | Dentist | 405 Capitol Street, The Parlor Suite, Charleston, WV 25301 | 2018-05-03 |
| 1104322320 | Kara Caldwell | Psychologist | 333 Laidley St., 4'th Floor East, Charleston, WV 25301 | 2018-04-05 |
| 1740638022 | Christina Phalen | Pharmacy Technician | 701 Lee Street East, Charleston, WV 25301 | 2016-05-27 |
| 1366867079 | Brooke Powell Garnes | Speech-Language Pathologist | 1313 Quarrier Street, Suite A, Charleston, WV 25301 | 2014-03-04 |
| 1952648404 | Implanted Pump Management, LLC | Home Infusion | 311 Laidley St., Suite 202, Charleston, WV 25301 | 2013-01-03 |
| 1730435108 | Chaitanya Mishra | Internal Medicine | 501 Morris St Ste 357, Charleston, WV 25301 | 2012-08-03 |
| 1033477278 | James Stephen Harman | Neurological Surgery | 415 Morris St Ste 400, Charleston, WV 25301 | 2012-04-25 |
| 1265674329 | Howard and Howard Dental LLC | Dentist | 1321 Virginia St., Charleston, WV 25301 | 2009-04-03 |
| 1881856144 | Steven David Hollosi | Emergency Medicine | 501 Morris St., Charleston, WV 25301 | 2008-06-27 |
| Find all providers in zip 25301 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164710562 | Ernest Stephen Fragale | Dentist | 405 Capitol St Ste 914, Charleston, WV 25301-1744 | 2011-07-19 |
| 1992018899 | Kool Smiles Sc-2, PC | Dentist | 4400 Dorchester Rd Ste 108, Charleston, SC 29405-6863 | 2010-07-20 |
| 1295975977 | Jason H. Cohen, Dmd, LLC | Dentist | 198 Rutledge Ave Ste 3, Charleston, SC 29403-5834 | 2009-02-20 |
| 1669692349 | Walter R. Long | Dentist | 10 Farmfield Ave Ste E, Charleston, SC 29407-7756 | 2007-04-26 |
| 1538386313 | Marc Levitan | Dentist | 173 Ashley Ave Rm 440 Bsb, Musc - Endodontics, Charleston, SC 29425-8908 | 2007-04-20 |
| 1548399793 | William H. Fournier Jr. | Dentist | 675 Saint Andrews Blvd, Charleston, SC 29407-7343 | 2007-03-05 |
| 1619049475 | Lora Beth Ford | Dentist | 112 Morris St, Charleston, WV 25301-2911 | 2006-11-15 |
| 1316021736 | Donald W Mcvicker | Dentist | 1064 Gardner Lane, Suite 103, Charleston, SC 29407 | 2006-10-24 |
| 1760406565 | John K Kuyk | Dentist | 405 Capitol St, Suite 914, Charleston, WV 25301-1749 | 2006-07-26 |
| 1437797495 | Jeffrey C Kotz Dmd Pa | Dentist | 742 Saint Andrews Blvd, Charleston, SC 29407-7169 | 2019-12-20 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25301 |
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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.