Healthcare Provider Details

I. General information

NPI: 1669308425
Provider Name (Legal Business Name): INFINITE SMILE DENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

5924 STONERIDGE DR STE 209A
PLEASANTON CA
94588-2887
US

IV. Provider business mailing address

5924 STONERIDGE DR STE 209A
PLEASANTON CA
94588-2887
US

V. Phone/Fax

Practice location:
  • Phone: 925-400-9978
  • Fax:
Mailing address:
  • Phone: 925-400-9978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY KAU
Title or Position: PRESIDENT
Credential: DDS
Phone: 925-400-9978