Provider Demographics
NPI:1265955017
Name:MARTIN, JANEL KALAR (DDS)
Entity type:Individual
Prefix:
First Name:JANEL
Middle Name:KALAR
Last Name:MARTIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JANEL
Other - Middle Name:NICOLE
Other - Last Name:KALAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:809 MINERAL RD
Mailing Address - Street 2:
Mailing Address - City:GLENVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26351-1385
Mailing Address - Country:US
Mailing Address - Phone:304-685-8464
Mailing Address - Fax:
Practice Address - Street 1:809 MINERAL RD
Practice Address - Street 2:
Practice Address - City:GLENVILLE
Practice Address - State:WV
Practice Address - Zip Code:26351-1385
Practice Address - Country:US
Practice Address - Phone:304-462-7343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-24
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV42681223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1841271459OtherWV CHIP
WV1841271459Medicaid