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Organization
DR. NANDAKA JAYAWEERA, DMD, PLLC
Active
Organization
DR. NANDAKA JAYAWEERA, DMD, PLLC
Active
Other names
Gentle Excellence Dental
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NANDAKA JAYAWEERA DMD (OWNER)
(502) 368-8400
Entity
Organization
Contact information
Practice address
4133 TAYLOR BLVD, LOUISVILLE, KY 40215-2341
(502) 368-8400
(502) 368-8423
Mailing address
4133 TAYLOR BLVD, LOUISVILLE, KY 40215-2341
(502) 368-8400
(502) 368-8423
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8777
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750511259
NANDAKA JAYAWEERA'S NPI NUMBER
KY
01
—
45608247
EPSDT
KY
05
—
7100194630
—
KY
Enumeration date
03/21/2012
Last updated
09/23/2015
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