Healthcare Provider Details

I. General information

NPI: 1528994498
Provider Name (Legal Business Name): DAVID KINES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 WILLIAM AVENUE #2
DAVIS WV
26260
US

IV. Provider business mailing address

PO BOX 217
DAVIS WV
26260-0217
US

V. Phone/Fax

Practice location:
  • Phone: 681-435-9050
  • Fax:
Mailing address:
  • Phone: 681-435-9050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4853
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: