NPIMap

Organization Active NPI

Usha Mantena Dental Corporation

Doing business as Vacaville Dentistry and Orthodontics Dental Group

  • Dentist
  • Vacaville, CA
National Provider Identifier
1073976361
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
USHA MANTENA DENTAL CORPORATION
Doing business as
Vacaville Dentistry and Orthodontics Dental Group
Practice address
671 Elmira Rd Ste 130
Vacaville, CA 95687-4655
Phone
(707) 215-5259
Fax
(707) 416-2828
NPI assigned
Apr 4, 2016
Last updated
Apr 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Authorized official

Name
Usha R Mantena, DMD
Title
Owner Doctor
Phone
(707) 215-5259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

671 Elmira Rd Ste 130
Vacaville, CA 95687-4655

Mailing address

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

Other names 1

  • Vacaville Dentistry and Orthodontics Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Usha Mantena Dental Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459728000000",
    "number": "1073976361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVENUE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "92614",
            "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": "671 ELMIRA RD STE 130",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956874655",
            "telephone_number": "707-215-5259",
            "fax_number": "707-416-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USHA MANTENA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A",
        "authorized_official_last_name": "MANTENA",
        "authorized_official_first_name": "USHA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "707-215-5259",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vacaville 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 Apr 4, 2016; 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.