Active NPI
Kenneth H Dolan, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Charleston, WV
National Provider Identifier
1821167495
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 60
- Practice address
- 1217 Virginia St E
Charleston, WV 25301 - Phone
- (304) 345-4960
- Fax
- (304) 345-4969
- NPI assigned
- Nov 7, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2275 | WV | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 60 | WV | Primary |
Addresses
Primary practice location
1217 Virginia St E
Charleston, WV 25301
Mailing address
1217 Virginia St E
Charleston, WV 25301
Phone (304) 345-4960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0137878000 | 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 |
|---|---|---|---|
| 60 | WV | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dolan & Kalaskey LTD | Dentist | 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 and National Provider Directory roles.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Charleston, WV
- NPI 1780893909
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354752000000",
"number": "1821167495",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1217 VIRGINIA ST E",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "25301",
"telephone_number": "304-345-4960",
"fax_number": "304-345-4969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1217 VIRGINIA ST E",
"city": "CHARLESTON",
"state": "WV",
"postal_code": "25301",
"telephone_number": "304-345-4960",
"fax_number": "304-345-4969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLAN",
"first_name": "KENNETH",
"middle_name": "H",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2012-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WV",
"license": "2275",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "WV",
"license": "60",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0137878000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charleston, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.