Lake Granbury Dental & Orthodontics PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20062 Issued in TX

Legal business name

LAKE GRANBURY DENTAL & ORTHODONTICS PLLC

Practice address

1200 Paluxy Medical Cir Ste 101
Granbury, TX 76048-5696

Phone

(817) 573-8338

NPI assigned

Dec 23, 2011

Organization subpart

No

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

Authorized official

Name

April Kaneira, D.D.S

Title

President

Phone

(214) 295-6805

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Adenike P Taiwo, D.M.D

  • Dentist
  • Gainesville, FL
  • NPI 1245543438

  General Practice

  NPD (past)

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

{
    "created_epoch": "1324598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324598400000",
    "number": "1942579602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PALUXY MEDICAL CIR STE 101",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PALUXY MEDICAL CIR STE 101",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760485696",
            "telephone_number": "817-573-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE GRANBURY DENTAL & ORTHODONTICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-23",
        "last_updated": "2011-12-23",
        "status": "A",
        "authorized_official_last_name": "KANEIRA",
        "authorized_official_first_name": "APRIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-295-6805",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "20062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Annette Kutas, OT
• Kyle W Rogers DDS Inc
• Laboratory Corporation of America
• Lake Granbury Chiropractic Center
• Lake Granbury Chiropractic Ctr.
• Lake Granbury HB Medical Services LLC
• Lake Granbury Hospital-Based Professional Services
• Lake Granbury Internal Medicine & Pediatrics, PA
• Lake Pointe Resource Center, Inc.
• Lakeshore ENT

• General Practice Dentistry in Granbury, TX
• Providers in Granbury, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; 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.