Kimberly Amanda Kaneshiro

Primary specialty

DentistTaxonomy code 122300000X

License

D1043 Issued in GU

Practice address

667 N Marine Corps Dr Ste 204
Tamuning, GU 96913-4429

Phone

(671) 646-3679

NPI assigned

Aug 4, 2020

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1225648322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26409",
            "city": "BARRIGADA",
            "state": "GU",
            "postal_code": "969216409",
            "telephone_number": "671-683-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "667 N MARINE CORPS DR STE 204",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "969134429",
            "telephone_number": "671-646-3679"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 N 12th St",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232985064",
            "country_code": "US",
            "telephone_number": "804-828-9190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANESHIRO",
        "first_name": "KIMBERLY",
        "middle_name": "AMANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GU",
            "license": "D1043",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0442000414",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Richmond",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "520 N 12th St",
            "city": "Richmond",
            "state": "VA",
            "country_code": "US",
            "postal_code": "232985064",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elwood Winfield Johnson
• Kwonil Jung
• Vasin Jungtrakoolchai, M.D.
• Kaiwa Wellness, LLC
• Sanjay V Kamath, MD
• Roger John Kaneshiro, DDS, MS
• Margaret Kang, PHARM.D.
• Shinik Kang, L. AC
• Steven Kasala
• Ari Katerelos, M.D.

• Dentist in Tamuning, GU
• Providers in Tamuning, GU by specialty
• Dentist in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.