Active NPI
Philip Mansour, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Goffstown, NH
National Provider Identifier
1306901897
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 2436
- Practice address
- 89 South Main Street
Goffstown, NH 03045 - Phone
- (603) 497-4605
- Fax
- (603) 497-3327
- NPI assigned
- Dec 26, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 2436 | NH | Primary |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 17193 | MA |
Addresses
Primary practice location
89 South Main Street
Goffstown, NH 03045
Mailing address
89 South Main St
Goffstown, NH 03045
Phone (603) 497-4605
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 |
|---|---|---|---|
| 17193 | MA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| 2436 | NH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306901897",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "89 SOUTH MAIN ST",
"city": "GOFFSTOWN",
"state": "NH",
"postal_code": "03045",
"telephone_number": "603-497-4605",
"fax_number": "603-497-3327"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 SOUTH MAIN STREET",
"city": "GOFFSTOWN",
"state": "NH",
"postal_code": "03045",
"telephone_number": "603-497-4605",
"fax_number": "603-497-3327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSOUR",
"first_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NH",
"license": "2436",
"primary": true
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "MA",
"license": "17193",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goffstown, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.