=====================================================
General NPI Number Information
=====================================================
NPI Number | 1114013299
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | APRIL L KANEIRA DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2006
-----------------------------------------------------
Last Update Date | 08/02/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 950 S FM 156 STE 10
-----------------------------------------------------
City | JUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76247-7042
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-488-6689
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4704 MARINER CT
-----------------------------------------------------
City | FLOWER MOUND
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75022-5469
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-914-0813
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 20062
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------