Healthcare Provider Details

I. General information

NPI: 1235895442
Provider Name (Legal Business Name): HARVEY PLAZA DENTAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2021
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 BECKLEY PLZ
BECKLEY WV
25801-2221
US

IV. Provider business mailing address

103 BECKLEY PLZ
BECKLEY WV
25801-2221
US

V. Phone/Fax

Practice location:
  • Phone: 304-527-8887
  • Fax: 304-407-3668
Mailing address:
  • Phone: 304-527-8887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY TODD HARVEY
Title or Position: OWNER
Credential: DDS
Phone: 304-573-1130