Kenneth L Banks, DDS
Individual provider Active NPI Dentist · Inwood, WV
NPI 1083897144 · NPPES record last updated Dec 12, 2007
Key facts
- NPI
- 1083897144
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 2765 (WV)
- Practice address
- 4325 Gerrardstown Road
Inwood, WV 25428-0722 - Phone
- (304) 229-2181
- Fax
- (304) 229-2291
- NPI assigned
- Dec 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2765 | WV | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2765 | WV | Yes |
Addresses
Primary practice location
4325 Gerrardstown Road
Inwood, WV 25428-0722
Mailing address
PO Box 722
Inwood, WV 25428-0722
Phone (304) 229-2181
Other providers in Inwood, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.