Individual provider Active NPI

Charles Anthony Manilla, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Hamilton, OH
National Provider Identifier
1295005304
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
15638 Issued in OH
Practice address
347 Park Ave
Hamilton, OH 45013-3051
Phone
(513) 737-6442
Fax
(513) 737-3501
NPI assigned
Jan 5, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 15638 OH Primary

Addresses

Primary practice location

347 Park Ave
Hamilton, OH 45013-3051

Mailing address

347 Park Ave
Hamilton, OH 45013-3051
Phone (513) 737-6442

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
15638OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Charles a Manilla D.D.S.,M,S.,Inc Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1295005304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 PARK AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450133051",
            "telephone_number": "513-737-6442",
            "fax_number": "513-737-3501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 PARK AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450133051",
            "telephone_number": "513-737-6442",
            "fax_number": "513-737-3501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANILLA",
        "first_name": "CHARLES",
        "middle_name": "ANTHONY",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "15638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; 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.