Cesar Humberto Cardenas, DMD, MS

Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Grayson, GA

NPI 1447287909 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1447287909
Entity type
Individual (NPI type 1)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
DN013156 (GA)
Practice address
2340 Loganville Hwy
Grayson, GA 30017-1621
Phone
(678) 969-9785
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
DN013156GAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Embrace Orthodontics Cumming LLC Current Accepting new patients
Bethlehem Orthodontics Current Accepting new patients
Commerce Orthodontics LLC Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DN013156 GA Yes

Addresses

Primary practice location

2340 Loganville Hwy
Grayson, GA 30017-1621

Mailing address

4810 Berkeley Walk PT
Berkeley Lake, GA 30096-6193
Phone (678) 969-9785

Other providers in Grayson, GA

All providers in Grayson, GA · Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.