=====================================================
General NPI Number Information
=====================================================
NPI Number | 1780893909
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOLAN & KALASKEY LTD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/22/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1217 VIRGINIA ST E
-----------------------------------------------------
City | CHARLESTON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-345-4960
-----------------------------------------------------
Fax | 304-345-4969
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1217 VIRGINIA ST E
-----------------------------------------------------
City | CHARLESTON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-345-4960
-----------------------------------------------------
Fax | 304-345-4969
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT TREASURER
-----------------------------------------------------
Name | KENNETH H DOLAN
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 304-345-4960
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 2275
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 3209
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | 60
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------
Taxonomy #4
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | 101
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------