Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ALDRENE ILANO MANASAN DMD
NPI 1295213254
Dentist - Endodontics in Fort Campbell, KY

Q: What is Aldrene Manasan's NPI number?

The NPI number for Aldrene Manasan is 1295213254. It was assigned to this individual provider in the NPPES registry on August 1, 2018.

Q: What is Aldrene Manasan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Q: When was this NPI record last updated?

The NPPES record for Aldrene Manasan was last updated on October 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 01, 2018

5979 DESERT STORM AVE, FORT CAMPBELL, KY 42223(270) 412-2787 Get Directions Write a Review

NPPES record last updated: October 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 10, 2026, Aug 5, 2026, Jul 1, 2024 and 2 more (5 updates tracked since 2018).

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About Aldrene Ilano Manasan Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALDRENE ILANO MANASAN DMD (NPI 1295213254) is an individual endodontics provider in Fort Campbell, Kentucky, licensed in Tennessee (13101) and active in the NPI registry since August 2018. He maintains 2 additional practice locations.

NPPES Registry Identity

NPI1295213254

Entity TypeIndividualMale

Primary Taxonomy1223E0200X

Provider Legal NameALDRENE ILANO MANASANCredential: DMD

Location Address5979 DESERT STORM AVEFort Campbell, KY 42223-5514

Mailing Address2110 Sylvan Lake DrGrovetown, GA 30813-5852 · (706) 787-5102

Phone(270) 412-2787

Sole ProprietorNo

Enumeration DateAugust 1, 2018

Last NPPES UpdateOctober 23, 20265 updates tracked since enumeration

NPPES CertifiedOctober 23, 2026

✔ NPI 1295213254 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDentist · EndodonticsDental Providers

Taxonomy Code1223E0200X

License✔ Licensed in TN · 13101

Definition

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Also ListedDentistTaxonomy 122300000X · License DDS102593 (CA)

Also ListedDentist · General PracticeTaxonomy 1223G0001X · License DDS102593 (CA)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License DDS102593 (CA)

5979 DESERT STORM AVE, Fort Campbell, KY 42223

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Secondary Practice Locations 2

Location 11466 Tiny Town Rd Ste AClarksville, TN 37042-8292 · Phone (931) 548-0119

Location 2228 E Hospital Rd Bldg 320Fort Eisenhower, GA 30905-6011 · Phone (706) 787-5102

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Guardian, Humana.Insurance ›

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DUKE PHU NGUYEN DMD

Dentist (General Practice)