Provider Demographics
NPI:1164707899
Name:KAPLAN, VANESSA J (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:J
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 THE NINES
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-2044
Mailing Address - Country:US
Mailing Address - Phone:805-868-0404
Mailing Address - Fax:
Practice Address - Street 1:3600 DELTA FAIR BLVD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-4006
Practice Address - Country:US
Practice Address - Phone:925-428-5820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-13
Last Update Date:2025-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA583911223X0400X
CO105881223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO45-3417167OtherFEIN