Paul R. Mancia, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DS017029-L Issued in PA

Practice address

500 3Rd Ave
Kingston, PA 18704-5810

Phone

(570) 331-0824

Fax

(570) 331-0827

NPI assigned

Jul 28, 2006

Last updated

Mar 24, 2016By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dental Specialists of Nepa

  • Endodontics
  • Kingston, PA
  • NPI 1407216526
  Authorized official Same address or phone
• Dental Specialists of Northeast PA Root Canal & Implant Dentistry PC

  • Endodontics
  • Hazleton, PA
  • NPI 1528364932
  NPD (past) Authorized official

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1316951049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 LAKESIDE DRIVE",
            "city": "HARVEY'S LAKE",
            "state": "PA",
            "postal_code": "18612",
            "telephone_number": "570-331-0824",
            "fax_number": "570-331-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 3RD AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187045810",
            "telephone_number": "570-331-0824",
            "fax_number": "570-331-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCIA",
        "first_name": "PAUL",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS017029-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara M Maculloch
• David Mallarkey Jr., RN
• Malsom Chiropractic PLLC (Legacy Chiropractic)
• Emily Amanda Malsom, DC
• Bonita M Mancia, M.D.
• Manor Care of Kingston PA LLC (ManorCare Health Services - Kingston)
• Tracy Lee Manzoni, OTR/L
• Michael Marchetti, RN
• Marguerite Mosack, PHD.
• Brian J Marien, MD

• Endodontics in Kingston, PA
• Providers in Kingston, PA by specialty
• Endodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.