Provider Demographics
NPI:1730116450
Name:CARDENAS, LINA M (DDS, MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:LINA
Middle Name:M
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:DDS, MS, PHD
Other - Prefix:DR
Other - First Name:LINA
Other - Middle Name:M
Other - Last Name:CARDENAS-DENTCHEV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 29732
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-0732
Mailing Address - Country:US
Mailing Address - Phone:210-380-4066
Mailing Address - Fax:
Practice Address - Street 1:102 PALO ALTO RD STE 400
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-3793
Practice Address - Country:US
Practice Address - Phone:210-924-8770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21471122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX160823409Medicaid
TX21471OtherTEXAS DENTAL LICENSE
TX88D731OtherBCBS
TX160823403Medicaid
TX160823407Medicaid