Jesse W. Manton, DDS, MS

Primary specialty

Dental AnesthesiologyTaxonomy code 1223D0004X

License

CA64852 Issued in CA

Practice address

155 5TH St
San Francisco, CA 94103-2919

Phone

(415) 929-6690

Fax

(415) 749-3305

NPI assigned

Mar 21, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• University of the Pacific

  • Pharmacotherapy Pharmacist
  • Stockton, CA
  • NPI 1295085413
  Medicare reassignment NPD
• University of the Pacific

  • Oral and Maxillofacial Surgery (Dentist)
  • San Francisco, CA
  • NPI 1508294927
  NPD

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1326465824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 5TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032919",
            "telephone_number": "415-929-6690",
            "fax_number": "415-749-3305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 5TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032919",
            "telephone_number": "415-929-6690",
            "fax_number": "415-749-3305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "410 W 10th Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432101240",
            "country_code": "US",
            "telephone_number": "614-293-8487",
            "fax_number": "614-293-8153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANTON",
        "first_name": "JESSE",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-21",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.025706",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "OH",
            "license": "30.025706",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "OH",
            "license": "30.25706",
            "primary": false
        },
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CA",
            "license": "CA64852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Gogan Manschreck, M.D.
• Kimia Mansoor, PSYD
• Addyson McKenna Mansperger
• Gregory Raymond Manteuffel, MD
• Jessica L. Mantia, PH.D.
• Mantra Speech Therapy, PC
• Kiernan Riley Manu
• Patricia Anne Manubay
• Darlene Manuel
• Frielyn Apostol Manuel, RN

• Dental Anesthesiology in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Dental Anesthesiology in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.