Provider Demographics
NPI:1063545416
Name:KANIA, ANN MINEO (DDS, DMSC)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:MINEO
Last Name:KANIA
Suffix:
Gender:F
Credentials:DDS, DMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 SAXONY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-2787
Mailing Address - Country:US
Mailing Address - Phone:760-642-0711
Mailing Address - Fax:760-642-0700
Practice Address - Street 1:345 SAXONY RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2787
Practice Address - Country:US
Practice Address - Phone:760-642-0711
Practice Address - Fax:760-642-0700
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics