Michael James Manzanares, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DD4653 Issued in NM

Practice address

13235 Emery Point Ave NE
Albuquerque, NM 87111-8244

Phone

(505) 670-0789

NPI assigned

Jun 30, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490659200000",
    "number": "1225489248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13235 EMERY POINT AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871118244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13235 EMERY POINT AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871118244",
            "telephone_number": "505-670-0789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANARES",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2017-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sloan Manuel
• Kyle McKenzie Manuelito
• Kathleen NMN Manygoats, MSW
• David James Manzanares, D.D.S.
• Lauren Casey Manzanares
• Patrick James Manzanares, LCSW, CHES
• Rosanna Yvette Manzanares, B.S
• Stefanie Manzanares, FNP-C, FNP-BC
• Manzanilla Health LLC
• Alexander Alberto Manzano Finol, MD

• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2017; 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.