Provider Demographics
NPI:1285273847
Name:CARDENAS DENTAL IMPLANTS AND ORAL SURGERY
Entity type:Organization
Organization Name:CARDENAS DENTAL IMPLANTS AND ORAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMEL
Authorized Official - Middle Name:GERARDO
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:956-216-7570
Mailing Address - Street 1:2121 PEASE ST STE 314
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8349
Mailing Address - Country:US
Mailing Address - Phone:956-216-7570
Mailing Address - Fax:956-216-7571
Practice Address - Street 1:5460 PAREDES LINE RD STE 197A
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-9742
Practice Address - Country:US
Practice Address - Phone:956-216-7570
Practice Address - Fax:956-216-7571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-31
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty