Healthcare Provider Details

I. General information

NPI: 1568522100
Provider Name (Legal Business Name): GEORGE S. DIRANI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1702 OAK ST
KENOVA WV
25530-1120
US

IV. Provider business mailing address

1702 OAK ST
KENOVA WV
25530-1120
US

V. Phone/Fax

Practice location:
  • Phone: 304-453-6765
  • Fax: 304-453-1695
Mailing address:
  • Phone: 304-453-6765
  • Fax: 304-453-1695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3322
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: