Active NPI
Jessica Lynn Manske, D.D.S.
- Pediatric Dentistry
- Los Angeles, CA
National Provider Identifier
1083926323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 59357
- Practice address
- 445 N Alfred St
Los Angeles, CA 90048-2504 - Phone
- (424) 354-9336
- NPI assigned
- Jul 1, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 59357 | CA | |
| Pediatric Dentistry | 1223P0221X | 59357 | CA | Primary |
Addresses
Primary practice location
445 N Alfred St
Los Angeles, CA 90048-2504
Mailing address
1355 N Sierra Bonita
#302
West Hollywood, CA 90046
Phone (424) 354-9336
Other practice location 1
1355 N Sierra Bonita Ave Apt 302
West Hollywood, CA 90046-8518
Phone (424) 354-9336
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manske Dental Corporation | Current | Accepting new patients |
Locations
8640 W 3rd St
Ste 202
Los Angeles, CA 90048
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722556800000",
"number": "1083926323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1355 N SIERRA BONITA",
"address_2": "#302",
"city": "WEST HOLLYWOOD",
"state": "CA",
"postal_code": "90046",
"telephone_number": "424-354-9336",
"fax_number": "424-322-4781"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "445 N ALFRED ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900482504",
"telephone_number": "424-354-9336"
}
],
"practiceLocations": [
{
"address_1": "1355 N Sierra Bonita Ave Apt 302",
"address_purpose": "LOCATION",
"city": "West Hollywood",
"state": "CA",
"postal_code": "900468518",
"country_code": "US",
"telephone_number": "424-354-9336",
"fax_number": "424-322-4781",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANSKE",
"first_name": "JESSICA",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-07-01",
"last_updated": "2024-08-02",
"certification_date": "2024-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "59357",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "59357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.