Active NPI
John D Mann, DDS
- Dentist
- Rohnert Park, CA
National Provider Identifier
1255454328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 38873
- Practice address
- 5200 Snyder Lane
Rohnert Park, CA 94928 - Phone
- (707) 584-9589
- Fax
- (707) 584-8057
- NPI assigned
- Apr 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 38873 | CA | Primary |
Addresses
Primary practice location
5200 Snyder Lane
Rohnert Park, CA 94928
Mailing address
5200 Snyder Lane
Rohnert Park, CA 99928
Phone (707) 584-9589
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160518001071 | CA | Order and Referring Only - Dentist | 5890084693 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199923200000",
"number": "1255454328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 SNYDER LANE",
"city": "ROHNERT PARK",
"state": "CA",
"postal_code": "99928",
"telephone_number": "707-584-9589",
"fax_number": "707-584-8057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 SNYDER LANE",
"city": "ROHNERT PARK",
"state": "CA",
"postal_code": "94928",
"telephone_number": "707-584-9589",
"fax_number": "707-584-8057"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANN",
"first_name": "JOHN",
"middle_name": "D",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2008-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "38873",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rohnert Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.