Provider Demographics
NPI:1972999399
Name:GODWIN, LAUREN YURA (DDS)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:YURA
Last Name:GODWIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:VICTORIA
Other - Last Name:YURA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 1587
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-1587
Mailing Address - Country:US
Mailing Address - Phone:304-293-6129
Mailing Address - Fax:304-293-7646
Practice Address - Street 1:1 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26506
Practice Address - Country:US
Practice Address - Phone:304-293-6129
Practice Address - Fax:304-293-7646
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3901122300000X
WV4148122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist