Individual provider Active NPI

John G Manning, DMD

  • Dentist
  • Point Lookout, NY
National Provider Identifier
1033281688
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
032066 Issued in NY
Practice address
21 Lido Blvd
Point Lookout, NY 11569
Phone
(516) 889-6169
Fax
(516) 889-5868
NPI assigned
Nov 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 032066 NY Primary

Addresses

Primary practice location

21 Lido Blvd
Point Lookout, NY 11569

Mailing address

PO Box 33
21 Lido Blvd
Point Lookout, NY 11569
Phone (516) 889-6169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160322001356 NY Order and Referring Only - DentistPractitioner - Dentist 3779880562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033281688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33",
            "address_2": "21 LIDO BLVD",
            "city": "POINT LOOKOUT",
            "state": "NY",
            "postal_code": "11569",
            "telephone_number": "516-889-6169",
            "fax_number": "516-889-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 LIDO BLVD",
            "city": "POINT LOOKOUT",
            "state": "NY",
            "postal_code": "11569",
            "telephone_number": "516-889-6169",
            "fax_number": "516-889-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANNING",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "032066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Point Lookout, NY

Sources for this page

Verify at the official NPI Registry.