Individual provider Active NPI

Craig Francis Mangie, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Cleveland, OH
National Provider Identifier
1003882333
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
16452 Issued in OH
Practice address
9500 Euclid Ave # Deska71
Cleveland, OH 44195-4501
Phone
(216) 444-4802
Fax
(216) 445-8570
NPI assigned
Feb 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 16452 OH Primary

Addresses

Primary practice location

9500 Euclid Ave # Deska71
Cleveland, OH 44195-4501

Mailing address

9500 Euclid Ave # Deska71
Cleveland, OH 44195-0001
Phone (216) 444-4802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16452OHMDOral and Maxillofacial Surgery (Dentist)

Networks

  • devoted network organization-9f3dfbd3-4aa6-4c92-8e71-9c4ed35ce037
  • devoted network organization-598bd2d4-c652-473f-ba7a-132f674c8eb6
  • devoted network organization-8ee96498-f86e-45f6-9fc9-a0f06c1636f9
  • KY PPO C-SNP

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1003882333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # DESKA71",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001",
            "telephone_number": "216-444-4802",
            "fax_number": "216-445-8570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE # DESKA71",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441954501",
            "telephone_number": "216-444-4802",
            "fax_number": "216-445-8570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIE",
        "first_name": "CRAIG",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "16452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.