Provider Demographics
NPI:1720770712
Name:CADENA, MANUELA (DMD)
Entity type:Individual
Prefix:
First Name:MANUELA
Middle Name:
Last Name:CADENA
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 1:7741 UPTON OXMOOR LN APT 311
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-3446
Mailing Address - Country:US
Mailing Address - Phone:407-342-4570
Mailing Address - Fax:
Practice Address - Street 1:13500 OLIVER STATION CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40245-2101
Practice Address - Country:US
Practice Address - Phone:502-244-4474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY10947122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist