Individual provider Active NPI

Roopa Manandhar, DDS

  • General Practice Dentistry
  • Bryan, TX
National Provider Identifier
1366738304
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27071 Issued in TX
Practice address
3111 S Texas Ave
Bryan, TX 77802-3124
Phone
(979) 446-0270
Fax
(979) 775-7641
NPI assigned
Jun 28, 2011
Last updated
Jun 28, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27071 TX Primary

Addresses

Primary practice location

3111 S Texas Ave
Bryan, TX 77802-3124

Mailing address

1090 Northchase Pkwy SE
Suite 290
Marietta, GA 30067-6405
Phone (770) 916-5362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231220001293 TX Order and Referring Only - DentistPractitioner - Dentist 2466763594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27071TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
BCS Family Dental , PLLC Current Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1366738304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1090 NORTHCHASE PKWY SE",
            "address_2": "SUITE 290",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300676405",
            "telephone_number": "770-916-5362",
            "fax_number": "678-247-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 S TEXAS AVE",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778023124",
            "telephone_number": "979-446-0270",
            "fax_number": "979-775-7641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANANDHAR",
        "first_name": "ROOPA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.