Provider Demographics
NPI:1730964693
Name:KAENPLOY, JEKITA (DDS)
Entity type:Individual
Prefix:
First Name:JEKITA
Middle Name:
Last Name:KAENPLOY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JEKITA
Other - Middle Name:
Other - Last Name:KAENPLOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:700 NW 4TH ST APT 228
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1684
Mailing Address - Country:US
Mailing Address - Phone:716-449-8455
Mailing Address - Fax:
Practice Address - Street 1:1201 N STONEWALL AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73117-1214
Practice Address - Country:US
Practice Address - Phone:405-271-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-29
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK431223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics