# DR. NANDAKA JAYAWEERA, DMD, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gentle Excellence Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548535776
- **Authorized official:** MR. NANDAKA JAYAWEERA DMD (OWNER)
- **Authorized official phone:** (502) 368-8400

## Contact information

- **Practice address:** 4133 TAYLOR BLVD, LOUISVILLE, KY 40215-2341
- **Practice address phone:** (502) 368-8400
- **Practice address fax:** (502) 368-8423
- **Mailing address:** 4133 TAYLOR BLVD, LOUISVILLE, KY 40215-2341
- **Mailing address phone:** (502) 368-8400
- **Mailing address fax:** (502) 368-8423

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 8777 | KY | Yes |

## Other

- **Enumeration date:** 03/21/2012
- **Last updated:** 09/23/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1750511259 | NANDAKA JAYAWEERA'S NPI NUMBER | KY |
| 01 | — | 45608247 | EPSDT | KY |
| 05 | — | 7100194630 | — | KY |