MEDICARE: DR. ANDREA ROSE CAIN-ROGERS DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	4334	WV
2	122300000X	Dentist	18542	MD
3	122300000X	Dentist	11747	NC
4	122300000X	Dentist	4334	WV

General Provider Information

NPI Number	:	1598258030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA ROSE CAIN-ROGERS DDS

Provider Business Mailing Address
First Line	:	1193 PINEVIEW DR
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-0481
Country	:	US
Telephone Number	:	304-599-8250
Fax Number	:

Provider Business Practice Location Address
First Line	:	1193 PINEVIEW DR
Second Line	:
City	:	MORGANTOWN
State	:	WV
Zip	:	26505-0481
Country	:	US
Telephone Number	:	304-599-8250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2018
Last Update Date	:	03/31/2026

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