Manuel J Fernandez III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35881 Issued in CA

Practice address

22600 Ventura Blvd
Suite 204
Woodland Hills, CA 91364-1414

Phone

(818) 225-0046

Fax

(818) 225-1318

NPI assigned

Jul 30, 2012

Sex

Male

Sole proprietor

No

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.

• Beard Apc & Fernandez Adc Dental Group

  • Dentist
  • Woodland Hills, CA
  • NPI 1215061627
  NPD Authorized official

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

• Manny Fernandez Professional name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 30, 2012.

{
    "created_epoch": "1343606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1124374962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22600 VENTURA BLVD",
            "address_2": "SUITE 204",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641414",
            "telephone_number": "818-225-0046",
            "fax_number": "818-225-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22600 VENTURA BLVD",
            "address_2": "SUITE 204",
            "city": "WOODLAND HILLS",
            "state": "CA",
            "postal_code": "913641414",
            "telephone_number": "818-225-0046",
            "fax_number": "818-225-1318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ",
        "first_name": "MANUEL",
        "middle_name": "J",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-30",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANNY",
            "last_name": "FERNANDEZ",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stephanie Bettina Ferguson
• Valerie Gail Ferguson, MSW LCSW DCSW
• Fiorella Fernandez-Davila
• Ethel Mariel C Fernandez
• Jocelyn Fernandez, BCAT
• Janine L Ferrante, LMFT
• Paula Regina Ferreira, DSCPT
• Markeline Margarita Ferrera
• Monica Ferrufino
• FFC Billing Corporation

• All providers in Woodland Hills, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.