Provider Demographics
NPI:1477994598
Name:KANKASH, SERENA J (DMD)
Entity type:Individual
Prefix:
First Name:SERENA
Middle Name:J
Last Name:KANKASH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 N MAIN ST STE 699
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-2029
Mailing Address - Country:US
Mailing Address - Phone:919-346-4711
Mailing Address - Fax:
Practice Address - Street 1:2038 LITHO PL
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-2518
Practice Address - Country:US
Practice Address - Phone:919-346-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2025-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC112431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry