NPIMap

Organization Active NPI

Mantena and Ghazal Dental Corporation

Doing business as Nut Tree Smiles Dentistry and Orthodontics Dental Group

  • General Practice Dentistry
  • Vacaville, CA
National Provider Identifier
1043589294
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MANTENA AND GHAZAL DENTAL CORPORATION
Doing business as
Nut Tree Smiles Dentistry and Orthodontics Dental Group
Practice address
110 Nut Tree Parkway
Vacaville, CA 95687
Phone
(707) 451-8390
Fax
(707) 451-8579
NPI assigned
Dec 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Authorized official

Name
Dr. Usha Mantena, DMD
Title
Owner Doctor
Phone
(707) 451-8390

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

110 Nut Tree Parkway
Vacaville, CA 95687

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Nut Tree Smiles Dentistry and Orthodontics Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

110 Nut Tree Pkwy
Vacaville, CA 95687
Phone (510) 778-2328

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1323993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384214400000",
    "number": "1043589294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 NUT TREE PARKWAY",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95687",
            "telephone_number": "707-451-8390",
            "fax_number": "707-451-8579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANTENA AND GHAZAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-16",
        "last_updated": "2013-11-12",
        "status": "A",
        "authorized_official_last_name": "MANTENA",
        "authorized_official_first_name": "USHA",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "707-451-8390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nut Tree Smiles Dentistry and Orthodontics Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vacaville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.