Albert B Canepa III, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE0007372 Issued in WA

Practice address

1405 SE 164TH Ave Ste 202
Vancouver, WA 98683-9644

Phone

(503) 284-6469

Fax

(503) 288-0842

NPI assigned

Oct 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Gehred Family Dental

  dba Wilshire Family Dental

  • General Practice Dentistry
  • Portland, OR
  • NPI 1043528169
  NPD (past)
• Gehred Family Dental

  • Dentist
  • Portland, OR
  • NPI 1699009605
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1790874899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE STE 202",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "360-514-0707",
            "fax_number": "360-514-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 SE 164TH AVE STE 202",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839644",
            "telephone_number": "503-284-6469",
            "fax_number": "503-288-0842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANEPA",
        "first_name": "ALBERT",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE0007372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loucel Candamo
• Alaina Nichole Candee, LMT
• Alexis Shawn Candelier, PSY.D.
• April Kristine Candiff
• Canepa Dental, LLC
• Kristi Lynn Canning-Lee, MS, LMHCA, LPC
• Brandy L Cannon, PA-C
• Breanne Cannon, PA-C
• Jessica Cannon
• Kathy Sue Canny, RD, CD, CDE

• General Practice Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.