Provider Demographics
NPI:1912320243
Name:JOEY L ADKINS DDS PLLC
Entity Type:Organization
Organization Name:JOEY L ADKINS DDS PLLC
Other - Org Name:ELK FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-965-6661
Mailing Address - Street 1:4968 ELK RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ELKVIEW
Mailing Address - State:WV
Mailing Address - Zip Code:25071-9297
Mailing Address - Country:US
Mailing Address - Phone:304-965-6661
Mailing Address - Fax:304-965-6684
Practice Address - Street 1:4968 ELK RIVER RD
Practice Address - Street 2:
Practice Address - City:ELKVIEW
Practice Address - State:WV
Practice Address - Zip Code:25071-9297
Practice Address - Country:US
Practice Address - Phone:304-965-6661
Practice Address - Fax:304-965-6684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3643122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810004124Medicaid
WV1666111OtherUNITED CONCORDIA