Active NPI
Edward A Manda, DDS
- General Practice Dentistry
- Lawrence, KS
National Provider Identifier
1275634917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5609
- Practice address
- 1425 Wakarusa Dr
Suite a
Lawrence, KS 66049-3832 - Phone
- (785) 841-1400
- NPI assigned
- Sep 26, 2006
- Last updated
- May 3, 2010
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5609 | KS | Primary |
Addresses
Primary practice location
1425 Wakarusa Dr
Suite a
Lawrence, KS 66049-3832
Mailing address
940 E 1264 Rd
Lawrence, KS 66047-9462
Phone (785) 841-1400
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5609 | KS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272844800000",
"number": "1275634917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "940 E 1264 RD",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660479462",
"telephone_number": "785-841-1400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1425 WAKARUSA DR",
"address_2": "SUITE A",
"city": "LAWRENCE",
"state": "KS",
"postal_code": "660493832",
"telephone_number": "785-841-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDA",
"first_name": "EDWARD",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-26",
"last_updated": "2010-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KS",
"license": "5609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrence, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.