Vanessa Antolinez Kai, DDS

Individual provider Active NPI General Practice Dentistry · Union City, CA

NPI 1386198166 · NPPES record last updated Jan 15, 2021

Key facts

NPI
1386198166
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
100635 (CA)
Practice address
2405 Gem Ave
Union City, CA 94587-5213
Phone
(408) 571-9502
NPI assigned
Aug 9, 2016
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210713001864 AZ Order and Referring Only - Dentist
Practitioner - Other (Physician)
Practitioner - Dentist
4082016027

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
100635CAMDSocial Worker
010522AZMDPediatric Dentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 010522 AZ
General Practice Dentistry 1223G0001X 100635 CA Yes

Addresses

Primary practice location

2405 Gem Ave
Union City, CA 94587-5213

Mailing address

703 N Abalone Dr
Gilbert, AZ 85233-0011
Phone (929) 319-5322

Other providers in Union City, CA

All providers in Union City, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.