Provider Demographics
NPI:1992140388
Name:CADELINIA, LOREN ANDREW (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:LOREN
Middle Name:ANDREW
Last Name:CADELINIA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:219 SAN FERNANDO WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1911
Mailing Address - Country:US
Mailing Address - Phone:415-608-6179
Mailing Address - Fax:
Practice Address - Street 1:2041 BRONZE STAR DR
Practice Address - Street 2:STE 100
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95776-5427
Practice Address - Country:US
Practice Address - Phone:530-662-7592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-30
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA612871223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics