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General NPI Number Information
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NPI Number | 1245949262
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Entity Type | Individual
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Provider Name | PAUL KANESHIRO DDS
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Gender | Male
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Dates
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Enumeration Date | 11/17/2022
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 1540 ROCK SPRINGS RD
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City | SMYRNA
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State | TN
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Zip | 37167-6141
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Country | US
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Telephone | 615-220-6161
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Fax | 615-220-6116
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Provider Business Mailing Address
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Address Line | 336 PARK CREEK RDG
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City | WOODSTOCK
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State | GA
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Zip | 30188-2158
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Country | US
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Telephone | 808-351-2191
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12827
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | N127582
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License Number State | GA
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