Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Country Club Dental PLLC

Organization General Practice Dentistry · NPI 1821959131

Country Club Dental PLLC is a 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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