NPIMap

Organization Active NPI

Laurie Manthos, D.M.D., P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Worcester, MA
National Provider Identifier
1285750596
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
16823 Issued in MA
Legal business name
LAURIE MANTHOS, D.M.D., P.C.
Practice address
200 Lincoln St
Suite 1
Worcester, MA 01605-2528
Phone
(508) 752-2100
NPI assigned
Mar 21, 2007
Last updated
Jan 11, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Authorized official

Name
Dr. Laurie Manthos, D.M.D.NPI 1295941607
Title
Owner
Phone
(508) 752-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 16823 MA Primary

Addresses

Primary practice location

200 Lincoln St
Suite 1
Worcester, MA 01605-2528

Mailing address

200 Lincoln St
Suite 1
Worcester, MA 01605-2528
Phone (508) 752-2100

National Provider Directory

National Provider Directory

Locations

200 Lincoln St
Ste 1
Worcester, MA 01605
Phone (508) 752-2100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200009600000",
    "number": "1285750596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LINCOLN ST",
            "address_2": "SUITE 1",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052528",
            "telephone_number": "508-752-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LINCOLN ST",
            "address_2": "SUITE 1",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052528",
            "telephone_number": "508-752-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURIE MANTHOS, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2008-01-11",
        "status": "A",
        "authorized_official_last_name": "MANTHOS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-752-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "16823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.