MEDICARE: DR. LOREN ANDREW CADELINIA D.D.S, M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	61287	CA

General Provider Information

NPI Number	:	1992140388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOREN ANDREW CADELINIA D.D.S, M.S.

Provider Business Mailing Address
First Line	:	219 SAN FERNANDO WAY
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94127-1911
Country	:	US
Telephone Number	:	415-608-6179
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 BRONZE STAR DR
Second Line	:	STE 100
City	:	WOODLAND
State	:	CA
Zip	:	95776-5427
Country	:	US
Telephone Number	:	530-662-7592
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2013
Last Update Date	:	05/28/2021

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