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General NPI Number Information
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NPI Number | 1386198166
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Entity Type | Individual
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Provider Name | VANESSA ANTOLINEZ KAI DDS
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Gender | Female
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Dates
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Enumeration Date | 08/09/2016
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 2405 GEM AVE
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City | UNION CITY
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State | CA
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Zip | 94587-5213
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Country | US
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Telephone | 408-571-9502
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Fax |
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Provider Business Mailing Address
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Address Line | 703 N ABALONE DR
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City | GILBERT
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State | AZ
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Zip | 85233-0011
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Country | US
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Telephone | 929-319-5322
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 010522
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License Number State | AZ
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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 | 100635
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License Number State | CA
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