Active NPI
Saman Khalil Manesh, D.D.S.
- Dentist
- Willows, CA
National Provider Identifier
1063757185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 62069
- Practice address
- 207 N Butte St
Willows, CA 95988-2803 - Phone
- (530) 934-4641
- NPI assigned
- Nov 29, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 62069 | CA | Primary |
| Dentist | 122300000X | 1479 | AK |
Addresses
Primary practice location
207 N Butte St
Willows, CA 95988-2803
Mailing address
207 N Butte St
Willows, CA 95988-2803
Phone (530) 934-4641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62069 | CA | MD | Dentist |
| 1479 | AK | MD | Adult Health Clinical Nurse Specialist |
Interoperability endpoints
- saman.manesh@nvih.eclinicaldirectplus.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491436800000",
"number": "1063757185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "207 N BUTTE ST",
"city": "WILLOWS",
"state": "CA",
"postal_code": "959882803",
"telephone_number": "530-934-4641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "207 N BUTTE ST",
"city": "WILLOWS",
"state": "CA",
"postal_code": "959882803",
"telephone_number": "530-934-4641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANESH",
"first_name": "SAMAN",
"middle_name": "KHALIL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-29",
"last_updated": "2017-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "62069",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AK",
"license": "1479",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willows, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.