Individual provider Active NPI

Thomas Jeffrey Manzione, DDS

  • General Practice Dentistry
  • Glen Head, NY
National Provider Identifier
1245389667
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0387531 Issued in NY
Practice address
25 Glen Head Road
Glen Head, NY 11545
Phone
(516) 671-1745
Fax
(516) 671-1745
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0387531 NY Primary

Addresses

Primary practice location

25 Glen Head Road
Glen Head, NY 11545

Mailing address

25 Glen Head Road
Glen Head, NY 11545
Phone (516) 671-1745

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

State licenses

LicenseStateTypeSpecialty
0387531NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245389667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 GLEN HEAD ROAD",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "11545",
            "telephone_number": "516-671-1745",
            "fax_number": "516-671-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 GLEN HEAD ROAD",
            "city": "GLEN HEAD",
            "state": "NY",
            "postal_code": "11545",
            "telephone_number": "516-671-1745",
            "fax_number": "516-671-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZIONE",
        "first_name": "THOMAS",
        "middle_name": "JEFFREY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0387531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Head, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.