Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Country Club Dental PLLC

Organization General Practice Dentistry · NPI 1821959131

Country Club Dental PLLC provides General Practice Dentistry in Fairmont, West Virginia. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1520 Country Club Rd
Fairmont, WV 26554-1353
Phone: (304) 363-9160
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X

Record details

NPI number1821959131
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Nadia Mardmomen — Member · (304) 672-9994
NPI enumeratedNovember 18, 2025
Last updated in NPPESNovember 18, 2025
Certification dateNovember 18, 2025
Mailing address80 Garden Cir, Bridgeport, WV 26330-1367

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