Healthcare Provider Details

I. General information

NPI: 1346651056
Provider Name (Legal Business Name): KENNETH Y. KAI, DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2014
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 MONTCLAIR AVE SUITE A
SAN JOSE CA
95116-1761
US

IV. Provider business mailing address

250 MONTCLAIR AVE SUITE A
SAN JOSE CA
95116-1761
US

V. Phone/Fax

Practice location:
  • Phone: 408-258-7141
  • Fax:
Mailing address:
  • Phone: 408-258-7141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNETH Y KAI
Title or Position: PRESIDENT
Credential: DDS
Phone: 408-258-7141