Patrick Christopher Manganello, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS038090 Issued in PA

Practice address

126 College Ave
Greenville, PA 16125-2166

Phone

(724) 301-3162

NPI assigned

Apr 9, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1239235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278460800000",
    "number": "1275776023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 COLLEGE AVE",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161252166",
            "telephone_number": "724-301-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 COLLEGE AVE",
            "city": "GREENVILLE",
            "state": "PA",
            "postal_code": "161252166",
            "telephone_number": "724-301-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGANELLO",
        "first_name": "PATRICK",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-09",
        "last_updated": "2010-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS038090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Domenick A Lombardo, M.A.
• Kylee Rae Loreno
• Patricia J. Madler, MSPT
• Rory Roth Mahoney
• John Manganello, D.M.D.
• Mariam Home Care Agency LLC
• Frank Marrapese, P.T.
• Diane E Marrie, CRNA
• Maybrook-C Whitecliff Opco LLC (The Grove at Greenville)
• McConnell Specific Chiropractic (Brent McConnell DC)

• General Practice Dentistry in Greenville, PA
• Providers in Greenville, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; 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.

Verify at the official NPI Registry.