Provider Demographics
NPI:1538953120
Name:LADERA, JONATHAN PAUL TOLENTINO (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN PAUL
Middle Name:TOLENTINO
Last Name:LADERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19600 EAST 39TH ST S, INDEPENDENCE, MO 64057, UNITED ST
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057
Mailing Address - Country:US
Mailing Address - Phone:913-396-3807
Mailing Address - Fax:
Practice Address - Street 1:19600 EAST 39TH ST S, INDEPENDENCE, MO 64057, UNITED ST
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057
Practice Address - Country:US
Practice Address - Phone:913-396-3807
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-08
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program