Guy R. Mancuso, DDS, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30162 Issued in CA

Legal business name

GUY R. MANCUSO, DDS, INC.

Practice address

14761 Pomerado Rd
Poway, CA 92064-2802

Phone

(858) 748-5815

Fax

(858) 748-6130

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Guy R Mancuso, D.D.S.NPI 1609903137

Title

Owner-Dentist

Phone

(858) 748-5815

Specialties & licenses 1

Addresses

Other names 1

• Twin Peaks Dentistry Doing business as

Locations

Practitioners 2

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

• Guy R Mancuso, D.D.S.

  • Dentist
  • Poway, CA
  • NPI 1609903137
  NPD (past) Authorized official
• Ziba Azim Shirazi, D.M.D

  • Dentist
  • Poway, CA
  • NPI 1578758017
  NPD (past)

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053448993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14761 POMERADO RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642802",
            "telephone_number": "858-748-5815",
            "fax_number": "858-748-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14761 POMERADO RD",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642802",
            "telephone_number": "858-748-5815",
            "fax_number": "858-748-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUY R. MANCUSO, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANCUSO",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER-DENTIST",
        "authorized_official_telephone_number": "858-748-5815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Peaks Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eduardo Gutierrez Diaz
• Amaranta Gutierrez Luna
• Geyma Gutierrez
• Itzia Gutierrez
• Rosben L Gutierrez, MD
• Justine Guy
• Naomu Guzman
• CHI D. Ha, M.D., FACS
• Tabitha Hageman
• Elizabeth Hahn

• General Practice Dentistry in Poway, CA
• Providers in Poway, CA by specialty
• General Practice Dentistry in California

• 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.