Active NPI
Manjiri Vartak, DDS
- Dentist
- Ventura, CA
National Provider Identifier
1346762002
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 102152
- Practice address
- 200 S Wells Rd Ste 225
Ventura, CA 93004-1382 - Phone
- (805) 659-0560
- Fax
- (805) 647-7164
- NPI assigned
- Jul 13, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 102152 | CA | Primary |
Addresses
Primary practice location
200 S Wells Rd Ste 225
Ventura, CA 93004-1382
Mailing address
1040 Flynn Rd
Camarillo, CA 93012-5092
Phone (805) 673-3930
Other practice location 1
4111 Fm 1764 Rd
Santa Fe, TX 77517-3853
Phone (409) 316-4254
Other practice location 2
200 S Wells Rd
Ventura, CA 93004-1377
Phone (805) 673-3930
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vartak DDS PLLC | Current | Accepting new patients | |
| Clinicas del Camino Real Inc | Past | Accepting new patients | |
| Clinicas del Camino Real Inc | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Pediatric Dentistry
- Dupont, WA
- NPI 1255220141
-
- Federally Qualified Health Center (FQHC)
- Camarillo, CA
- NPI 1295297190
-
- Federally Qualified Health Center (FQHC)
- Oxnard, CA
- NPI 1942789359
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1346762002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 FLYNN RD",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930125092",
"telephone_number": "805-673-3930",
"fax_number": "805-659-3217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 S WELLS RD STE 225",
"city": "VENTURA",
"state": "CA",
"postal_code": "930041382",
"telephone_number": "805-659-0560",
"fax_number": "805-647-7164"
}
],
"practiceLocations": [
{
"address_1": "4111 Fm 1764 Rd",
"address_purpose": "LOCATION",
"city": "Santa Fe",
"state": "TX",
"postal_code": "775173853",
"country_code": "US",
"telephone_number": "409-316-4254",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "200 S Wells Rd",
"address_purpose": "LOCATION",
"city": "Ventura",
"state": "CA",
"postal_code": "930041377",
"country_code": "US",
"telephone_number": "805-673-3930",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VARTAK",
"first_name": "MANJIRI",
"name_prefix": "Ms.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-07-13",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "102152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.