Individual provider Active NPI

Matthew William Mangino, DMD

  • General Practice Dentistry
  • Loveland, OH
National Provider Identifier
1245468495
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9115 Issued in KY
Practice address
8944 Columbia Rd
Loveland, OH 45140-1121
Phone
(513) 774-8800
Fax
(513) 774-5314
NPI assigned
Jun 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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 9115 KY Primary

Addresses

Primary practice location

8944 Columbia Rd
Loveland, OH 45140-1121

Mailing address

5154 Village Square Dr
Paducah, KY 42001-9060
Phone (270) 444-6414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20160303002597 KY Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2860798675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Walden & Bridges Partnership Dentistry General Practice Past Accepting new patients
Pinnacle One Dental Group, Delisle, P.C. General Practice Past Accepting new patients

Organizations & group practices 2

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": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1245468495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5154 VILLAGE SQUARE DR",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420019060",
            "telephone_number": "270-444-6414",
            "fax_number": "270-444-6488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8944 COLUMBIA RD",
            "city": "LOVELAND",
            "state": "OH",
            "postal_code": "451401121",
            "telephone_number": "513-774-8800",
            "fax_number": "513-774-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGINO",
        "first_name": "MATTHEW",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-26",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loveland, OH

Sources for this page

Verify at the official NPI Registry.