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General NPI Number Information
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NPI Number | 1689351116
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Entity Type | Individual
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Provider Name | GINOVELLI KEI KOTAKE SILVESTRE DDS
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Gender | Male
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 1220 COIT RD STE 106
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City | PLANO
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State | TX
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Zip | 75075-7757
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Country | US
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Telephone | 972-645-4100
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Fax |
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Provider Business Mailing Address
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Address Line | 659 JUNCTION DR APT F103
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City | ALLEN
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State | TX
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Zip | 75013-5146
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 39753
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License Number State | TX
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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 | 39753
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License Number State | TX
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