Stephen James Mangan, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN18777 Issued in FL

Practice address

1625 E Las Olas Blvd
Fort Lauderdale, FL 33301-2357

Phone

(954) 463-5051

NPI assigned

Mar 11, 2010

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 FL

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

Practice roles

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.

• Ty J Eriks DMD Corp

  • General Practice Dentistry
  • Boynton Beach, FL
  • NPI 1659143352
  NPD (past)

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

{
    "created_epoch": "1268265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1316260854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SE 5TH CT",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333013005",
            "telephone_number": "954-655-0251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E LAS OLAS BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012357",
            "telephone_number": "954-463-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGAN",
        "first_name": "STEPHEN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-11",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN18777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayerli Alejandra Mancia, BEHAVIOR TECHNICIAN
• Vanessa Lynn Mancuso, DDS, MSD
• Jeffrey D Mandelkorn
• Barbara Mandrisch, OT
• Anele Ramia Manfredini, M.D.
• Monique Lenore Manganelli, MD
• Benson Scott Mangleburg, RPH
• Nisha S Mani, MD
• Adina Manica
• Geneva Manilova

• Endodontics in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Endodontics in Florida

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