Antoinette Cancelada, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60839 Issued in KS

Practice address

104 S Desmet LN Ste 6
Saint Marys, KS 66536-9826

Phone

(785) 321-3455

NPI assigned

Sep 3, 2012

Last updated

Jan 6, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Flinthillsdentalpa

  • Dentist
  • Saint Marys, KS
  • NPI 1780224121
  NPD Authorized official
• J.Warren Hildreth, Jr., DDS PA

  dba St. Marys Dental Center

  • General Practice Dentistry
  • Saint Marys, KS
  • NPI 1962782680
  NPD (past)

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

{
    "created_epoch": "1346630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1942559224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 129",
            "city": "SAINT MARYS",
            "state": "KS",
            "postal_code": "665360129",
            "telephone_number": "785-321-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S DESMET LN STE 6",
            "city": "SAINT MARYS",
            "state": "KS",
            "postal_code": "665369826",
            "telephone_number": "785-321-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANCELADA",
        "first_name": "ANTOINETTE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-03",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "admin@flinthillsdentalpa.us",
            "affiliation": "N",
            "endpointDescription": "work email",
            "address_1": "104 S Desmet Ln Ste 6",
            "city": "Saint Marys",
            "state": "KS",
            "country_code": "US",
            "postal_code": "665369826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alternative Healthcare of St Marys, PA.
• Back to Health Wellness, Inc (St. Marys Chiropractic)
• Patricia Ann Bashaw-Schmaltz, P.T.
• Carl Carroll, M.D.
• Verne Claussen, OD
• Community Healthcare System, Inc (St Marys Clinic)
• Community Healthcare System, Inc (St Marys Manor)
• Craig F Schmaltz SP (Kaw Valley Phys Ther & Tng Center)

• General Practice Dentistry in Saint Marys, KS
• Providers in Saint Marys, KS by specialty
• General Practice Dentistry in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.