Kathryn Ann Hackenberg Cardenas, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 16555 Issued in FL

Practice address

109 Nature Walk Pkwy
St Augustine, FL 32092-5059

Phone

(904) 497-4343

Fax

(904) 484-7563

NPI assigned

Mar 13, 2007

Last updated

May 4, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 8, 2022 through Nov 8, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Whispering Pines Dental, LLC

  • General Practice Dentistry
  • St Augustine, FL
  • NPI 1598479511
  NPD
• Baker Restorative PLLC

  • Dental Clinic/Center
  • Macclenny, FL
  • NPI 1861328825
  NPD (past)
• Margaret L. Romeo, D.M.D.,P.a.

  • General Practice Dentistry
  • Macclenny, FL
  • NPI 1497972541
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1639202658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 NATURE WALK PKWY UNIT 105",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320925065",
            "telephone_number": "904-497-4343",
            "fax_number": "904-484-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 NATURE WALK PKWY",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320925059",
            "telephone_number": "904-497-4343",
            "fax_number": "904-484-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDENAS",
        "first_name": "KATHRYN",
        "middle_name": "ANN HACKENBERG",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 16555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexis Rae Capria
• Richard A Caputo, M.D.
• Ernesto J. Carames, M.D.
• Carol Mehlberg Carberry, BA
• David Michael Carbonara, PT
• Susan Cardiff-Reed, LCSW
• Cardiovascular Consultants of St Augustine PL
• Elizabeth Cardy, M.A.
• Care for the Body & Soul
• Caregiver Holdings of Amelia LLC (Coral Landing)

• General Practice Dentistry in St Augustine, FL
• Providers in St Augustine, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.