MEDICARE: DR. JOSHIKA KANABAR D.D.S., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	21456	TX

General Provider Information

NPI Number	:	1063636074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSHIKA KANABAR D.D.S., M.S.

Provider Business Mailing Address
First Line	:	9669 N CENTRAL EXPY STE 105
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-5056
Country	:	US
Telephone Number	:	214-692-5688
Fax Number	:	972-364-1208

Provider Business Practice Location Address
First Line	:	9669 N CENTRAL EXPY STE 105
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-5056
Country	:	US
Telephone Number	:	214-692-5688
Fax Number	:	972-364-1208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	01/16/2018

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