Active NPI
William Adam Klenk, DDS
- Dentist
- Hico, WV
National Provider Identifier
1548246945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2864
- Practice address
- 26496 Midland Trail
Hico, WV 25854-0497 - Phone
- (304) 658-5282
- Fax
- (304) 658-5299
- NPI assigned
- Dec 16, 2005
- Last updated
- Oct 11, 2012
- Sex
- Male
- 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 | 2864 | WV | Primary |
Addresses
Primary practice location
26496 Midland Trail
Hico, WV 25854-0497
Mailing address
PO Box 497
26496 Midland Trail
Hico, WV 25854-0497
Phone (304) 658-5282
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0132483000 | Medicaid | WV |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2864 | WV | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William a. Klenk DDS, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Hico, WV
- NPI 1255582219
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349913600000",
"number": "1548246945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 497",
"address_2": "26496 MIDLAND TRAIL",
"city": "HICO",
"state": "WV",
"postal_code": "258540497",
"telephone_number": "304-658-5282",
"fax_number": "304-658-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26496 MIDLAND TRAIL",
"city": "HICO",
"state": "WV",
"postal_code": "258540497",
"telephone_number": "304-658-5282",
"fax_number": "304-658-5299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLENK",
"first_name": "WILLIAM",
"middle_name": "ADAM",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-16",
"last_updated": "2012-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "2864",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0132483000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hico, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.