Active NPI
John Manganello, D.M.D.
- General Practice Dentistry
- Greenville, PA
National Provider Identifier
1336168806
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS20863L
- Practice address
- 126 College Ave
Greenville, PA 16125-2166 - Phone
- (724) 588-3012
- Fax
- (724) 588-0922
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS20863L | PA | Primary |
Addresses
Primary practice location
126 College Ave
Greenville, PA 16125-2166
Mailing address
126 College Ave
Greenville, PA 16125-2166
Phone (724) 588-3012
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS20863L | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336168806",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "126 COLLEGE AVE",
"city": "GREENVILLE",
"state": "PA",
"postal_code": "161252166",
"telephone_number": "724-588-3012",
"fax_number": "724-588-0922"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "126 COLLEGE AVE",
"city": "GREENVILLE",
"state": "PA",
"postal_code": "161252166",
"telephone_number": "724-588-3012",
"fax_number": "724-588-0922"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGANELLO",
"first_name": "JOHN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS20863L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, PA
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.