Abigail Alyssa Aviles Manahan

Primary specialty

DentistTaxonomy code 122300000X

License

DDS106983 Issued in CA

Practice address

24021 Alessandro Blvd Ste A120
Moreno Valley, CA 92553-6710

Phone

(951) 242-3328

Fax

(951) 924-1134

NPI assigned

Dec 7, 2021

Sex

Female

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)

Not enrolled

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.

• Zapanta-Chavez, DDS, Inc.

  • Dentist
  • Moreno Valley, CA
  • NPI 1326561143
  NPD

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1326706268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11160 RICHIE CIRCLE APT B",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542951",
            "telephone_number": "909-569-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24021 ALESSANDRO BLVD STE A120",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925536710",
            "telephone_number": "951-242-3328",
            "fax_number": "951-924-1134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANAHAN",
        "first_name": "ABIGAIL ALYSSA",
        "middle_name": "AVILES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS106983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malibu Transportation LLC
• Kristen Audrey Malloy
• Kameelah R Malone
• Sharee L Malone
• Cesar Mamani, DDS
• Tyler Manalo
• Ketsuree Maneewong
• Nathalie Saray Manriquez
• Mansfield Professional Medical Corporation
• Kat Manzo

• Dentist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.