Raymond D.Manniello,D.D.S.,P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

MA18081 Issued in MA

Legal business name

RAYMOND D.MANNIELLO,D.D.S.,P.C.

Practice address

264 N Main St
Suite 4
East Longmeadow, MA 01028-1815

Phone

(413) 525-0861

NPI assigned

Apr 17, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raymond MannielloNPI 1992824650

Title

President

Phone

(413) 525-0861

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Raymond Manniello, D.D.S.

  • General Practice Dentistry
  • East Longmeadow, MA
  • NPI 1992824650
  NPD (past) Authorized official

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023234150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010281815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010281815",
            "telephone_number": "413-525-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMOND D.MANNIELLO,D.D.S.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANNIELLO",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "413-525-0861"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "MA18081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "MA18081",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in East Longmeadow, MA
• Providers in East Longmeadow, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.