Active NPI
Katelyn Hineman, DDS
- Dentist
- Fairmont, WV
National Provider Identifier
1063339075
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4880
- Practice address
- 403 Virginia Ave
Fairmont, WV 26554-2748 - Phone
- (304) 366-3910
- NPI assigned
- Jul 1, 2026
- Last updated
- Jul 1, 2026
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4880 | WV | Primary |
Addresses
Primary practice location
403 Virginia Ave
Fairmont, WV 26554-2748
Mailing address
403 Virginia Ave
Fairmont, WV 26554-2748
Other practice location 1
1801 Earl L Core Rd
Morgantown, WV 26505-5893
Phone (304) 292-4412
Other practice location 2
1016 Maple Dr Ste 103
Morgantown, WV 26505-2893
Phone (304) 599-6550
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Michael F Trent & Michael J Meador DDS Inc | Dentist | Past | Accepting new patients |
| DRS Wilson and Martino of Fairmont, PLLC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dentist
- Fairmont, WV
- NPI 1831380443
-
- Dentist
- Fairmont, WV
- NPI 1598851958
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1782864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1782864000000",
"number": "1063339075",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "403 VIRGINIA AVE",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265542748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "403 VIRGINIA AVE",
"city": "FAIRMONT",
"state": "WV",
"postal_code": "265542748",
"telephone_number": "304-366-3910"
}
],
"practiceLocations": [
{
"address_1": "1801 Earl L Core Rd",
"address_purpose": "LOCATION",
"city": "Morgantown",
"state": "WV",
"postal_code": "265055893",
"country_code": "US",
"telephone_number": "304-292-4412",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1016 Maple Dr Ste 103",
"address_purpose": "LOCATION",
"city": "Morgantown",
"state": "WV",
"postal_code": "265052893",
"country_code": "US",
"telephone_number": "304-599-6550",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HINEMAN",
"first_name": "KATELYN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-07-01",
"last_updated": "2026-07-01",
"certification_date": "2026-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "4880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairmont, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.