Provider Demographics
NPI:1366213084
Name:MAYDANA-CAVANAUGH, CLAUDIA FABIOLA
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:FABIOLA
Last Name:MAYDANA-CAVANAUGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6131 FOSTER MILL DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-3445
Mailing Address - Country:US
Mailing Address - Phone:636-639-0847
Mailing Address - Fax:
Practice Address - Street 1:6131 FOSTER MILL DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-3445
Practice Address - Country:US
Practice Address - Phone:636-639-0847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-11
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist