NPIMap

Organization Active NPI

Amana Dental Corp.

  • General Practice Dentistry
  • Minneapolis, MN
National Provider Identifier
1275770596
Registry record updated Jan 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D 11855 Issued in MN
Legal business name
AMANA DENTAL CORP.
Practice address
2326 Central Ave NE
Minneapolis, MN 55418-3710
Phone
(612) 789-2928
Fax
(612) 789-2783
NPI assigned
Jan 8, 2009
Last updated
Jan 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2009

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

Authorized official

Name
Dr. Mazen Manla, DDS
Title
Presedent
Phone
(312) 451-4050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X D 11855 MN Primary

Addresses

Primary practice location

2326 Central Ave NE
Minneapolis, MN 55418-3710

Mailing address

2326 Central Ave NE
Minneapolis, MN 55418-3710
Phone (612) 789-2928

National Provider Directory

National Provider Directory

Locations

2326 Central Ave NE
Minneapolis, MN 55418
Phone (612) 789-2928

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231372800000",
    "number": "1275770596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2326 CENTRAL AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183710",
            "telephone_number": "612-789-2928",
            "fax_number": "612-789-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2326 CENTRAL AVE NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554183710",
            "telephone_number": "612-789-2928",
            "fax_number": "612-789-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANA DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2009-01-08",
        "status": "A",
        "authorized_official_last_name": "MANLA",
        "authorized_official_first_name": "MAZEN",
        "authorized_official_title_or_position": "PRESEDENT",
        "authorized_official_telephone_number": "312-451-4050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D 11855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2009; 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.