Provider Demographics
NPI:1811445380
Name:WELINSKY, KEVIN (DDS)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:WELINSKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 LASALLE ROAD
Mailing Address - Street 2:YORK BLDG SUITE 507
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21286-2013
Mailing Address - Country:US
Mailing Address - Phone:410-321-8480
Mailing Address - Fax:410-321-8482
Practice Address - Street 1:8600 LASALLE ROAD
Practice Address - Street 2:YORK BLDG SUITE 507
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-2013
Practice Address - Country:US
Practice Address - Phone:410-321-8480
Practice Address - Fax:410-321-8482
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD159901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD777747700Medicaid