Aldrene Ilano Manasan, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

13101 Issued in TN

Practice address

5979 Desert Storm Ave
Fort Campbell, KY 42223-5514

Phone

(270) 412-2787

NPI assigned

Aug 1, 2018

Last updated

Oct 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792713600000",
    "number": "1295213254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 SYLVAN LAKE DR",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308135852",
            "telephone_number": "706-787-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5979 DESERT STORM AVE",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235514",
            "telephone_number": "270-412-2787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1466 Tiny Town Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370428292",
            "country_code": "US",
            "telephone_number": "931-548-0119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "228 E Hospital Rd Bldg 320",
            "address_purpose": "LOCATION",
            "city": "Fort Eisenhower",
            "state": "GA",
            "postal_code": "309056011",
            "country_code": "US",
            "telephone_number": "706-787-5102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANASAN",
        "first_name": "ALDRENE",
        "middle_name": "ILANO",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS102593",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TN",
            "license": "13101",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS102593",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "DDS102593",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cecelia Frances Maier, LCSW
• Amy Maki
• Becky Maldonado
• Kristen Jennifer Malone, BSN, RN, CCM
• Amanda Maloney, OTR, OTD
• Brandi Mangan, FNP-C
• Dorothy Hamlet Manning, PHARMACIST
• Patrick G Manrique, DPT
• Taylor Daniel Mansfield, MD
• Gabrielle Erin Avera Marcellino, MD

• Endodontics in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Endodontics in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.