Steven Scott Kanetzke, D.D.S.
Individual provider Active NPI General Practice Dentistry · Vinton, VA
NPI 1386865657 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1386865657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0401005770 (VA)
- Practice address
- 224 W Virginia Ave
Vinton, VA 24179-3318 - Phone
- (540) 342-8756
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401005770 | VA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CLQ&P Dentistry PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401005770 | VA | Yes |
Addresses
Primary practice location
224 W Virginia Ave
Vinton, VA 24179-3318
Mailing address
1015 Highland Dr
Roanoke, VA 24019-7232
Phone (540) 309-5078
Other providers in Vinton, VA
- Jennifer Horsley
- Shemeka Hough
- Patricia M. Jones
- Joseph Charles Joyce
- JTW Pharmacy Inc
- George Kevorkian Jr.
- Lisa M Kilgore
- Todd A King
- Jenna Terese Knaus
- Emily Knopf
All providers in Vinton, VA · General Practice Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.