Manuela Avila, DDS
Individual provider Active NPI General Practice Dentistry · Blue Springs, MO
NPI 1043777501 · NPPES record last updated Feb 20, 2019
Key facts
- NPI
- 1043777501
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 2018043082 (MO)
- Practice address
- 1205 NE Coronado Dr
Blue Springs, MO 64014-2928 - Phone
- (816) 228-4090
- NPI assigned
- Feb 20, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alex Sharifian DDS Blue Springs Dentistry PC | General Practice | Past | Accepting new patients |
| Preventative Care Health Services, Inc | Past | Accepting new patients | |
| Preventative Care Health Service, Inc. | Past | Accepting new patients |
Interoperability endpoints
- manuela.avila.p1@direct.preventativehealth.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2018043082 | MO | Yes |
Addresses
Primary practice location
1205 NE Coronado Dr
Blue Springs, MO 64014-2928
Mailing address
117 W 20TH St Apt 409
Kansas City, MO 64108-2080
Phone (915) 497-5338
Other providers in Blue Springs, MO
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- Ashlynn Arth
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- George M Austin
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- Robert Kyle Avondet
- Gladys Azzun-Baumgartner
- Shelby Bachman
- Deanna Marie Bafus
- Ashley John Bahr
All providers in Blue Springs, MO · General Practice Dentistry in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.