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General NPI Number Information
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NPI Number | 1932420221
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Entity Type | Organization
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Legal Business Name | WILSHIRE FAMILY DENTAL AND ORTHODONTICS PLLC
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Dates
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Enumeration Date | 06/21/2010
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Last Update Date | 05/11/2025
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Provider Practice Location Address
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Address Line | 950 FM 156 SUITE 10
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City | JUSTIN
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State | TX
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Zip | 76247
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Country | US
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Telephone | 940-648-8668
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Fax | 940-648-8668
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Provider Business Mailing Address
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Address Line | 950 FM 156 SUITE 10
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City | JUSTIN
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State | TX
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Zip | 76247
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Country | US
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Telephone | 940-648-8668
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Fax | 940-648-8668
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MRS. APRIL KANEIRA
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Credential | DDS
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Telephone | 214-914-0813
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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 | 20062
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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 | 20062
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License Number State | TX
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