Vincent R Mancuso, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-016451 Issued in OH

Practice address

1730 West 25TH Street
Cleveland, OH 44113-3108

Phone

(216) 861-5330

Fax

(216) 623-7596

NPI assigned

Jul 18, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18241/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1225056971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 WEST 25TH STREET",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133108",
            "telephone_number": "216-861-5330",
            "fax_number": "216-623-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 WEST 25TH STREET",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441133108",
            "telephone_number": "216-861-5330",
            "fax_number": "216-623-7596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "VINCENT",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-016451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0490142",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittani Katherine Mancini, LPC
• Kathryn Jane Mancini, M.A.
• Laura Ann Mancini, CNP
• Jennfier Mancino
• Nicolina Letizia Mancino, PHARMD
• Anna M Mandalakas, MD
• Aida L Mandapat, MD
• Maria Mandato
• Shannon Dee Mandato
• Gabriel Mandel, MD

• General Practice Dentistry in Cleveland, OH
• Providers in Cleveland, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2012; 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.