Individual provider Active NPI

Jon M Kanegawa, DDS

  • Dentist
  • Reading, PA
National Provider Identifier
1194925263
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS023762L Issued in PA
Practice address
4462 Boyertown Pike
Reading, PA 19606
Phone
(610) 779-7766
Fax
(610) 779-7767
NPI assigned
Jul 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS023762L PA Primary

Addresses

Primary practice location

4462 Boyertown Pike
Reading, PA 19606

Mailing address

4462 Boyertown Pike
Reading, PA 19606
Phone (610) 779-7766

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1194925263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4462 BOYERTOWN PIKE",
            "city": "READING",
            "state": "PA",
            "postal_code": "19606",
            "telephone_number": "610-779-7766",
            "fax_number": "610-779-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4462 BOYERTOWN PIKE",
            "city": "READING",
            "state": "PA",
            "postal_code": "19606",
            "telephone_number": "610-779-7766",
            "fax_number": "610-779-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANEGAWA",
        "first_name": "JON",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS023762L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.