| Gentle Excellence Dental | |
|
4133 Taylor Blvd Louisville KY 40215-2341 | |
| (502) 368-8400 | |
| (502) 368-8423 |
| Full Name | Gentle Excellence Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4133 Taylor Blvd, Louisville, Kentucky |
| Authorized Official Name and Position | Nandaka Jayaweera (OWNER) |
| Authorized Official Contact | 5023688400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gentle Excellence Dental 4133 Taylor Blvd Louisville KY 40215-2341 Ph: (502) 368-8400 | Gentle Excellence Dental 4133 Taylor Blvd Louisville KY 40215-2341 Ph: (502) 368-8400 |
| NPI Number | 1548535776 |
|---|---|
| Provider Enumeration Date | 03/21/2012 |
| Last Update Date | 09/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548535776 | NPI | - | NPPES |
| 1750511259 | Other | KY | NANDAKA JAYAWEERA'S NPI NUMBER |
| 45608247 | Other | KY | EPSDT |
| 7100194630 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8777 (Kentucky) | Primary |
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