Provider Demographics
NPI:1346246741
Name:ROY, JOEY A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEY
Middle Name:A
Last Name:ROY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 408
Mailing Address - Street 2:
Mailing Address - City:WEST HAMLIN
Mailing Address - State:WV
Mailing Address - Zip Code:25571-0408
Mailing Address - Country:US
Mailing Address - Phone:304-824-7704
Mailing Address - Fax:304-824-7705
Practice Address - Street 1:1616 13TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3840
Practice Address - Country:US
Practice Address - Phone:304-691-1247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVD25771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0136669000Medicaid