Active NPI
Joel Esteban Manchego, D.D.S.
- General Practice Dentistry
- Gastonia, NC
National Provider Identifier
1295090165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9364
- Practice address
- 816 E Franklin Blvd
Gastonia, NC 28054-4241 - Phone
- (704) 396-6166
- NPI assigned
- Jul 6, 2012
- Sex
- Male
- Sole proprietor
- No
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 | 9364 | NC | Primary |
Addresses
Primary practice location
816 E Franklin Blvd
Gastonia, NC 28054-4241
Mailing address
3770 Spring Willow Way
Winston Salem, NC 27107-6053
Phone (336) 422-2463
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 |
|---|---|---|---|
| 9364 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341532800000",
"number": "1295090165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3770 SPRING WILLOW WAY",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271076053",
"telephone_number": "336-422-2463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 E FRANKLIN BLVD",
"city": "GASTONIA",
"state": "NC",
"postal_code": "280544241",
"telephone_number": "704-396-6166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCHEGO",
"first_name": "JOEL",
"middle_name": "ESTEBAN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-06",
"last_updated": "2012-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "9364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gastonia, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 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.