Individual provider Active NPI

Danielle Gail English-Mangum, DDS

  • General Practice Dentistry
  • Roanoke Rapids, NC
National Provider Identifier
1376879726
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8812 Issued in NC
Practice address
2064 NC Highway 125
Roanoke Rapids, NC 27870-9436
Phone
(252) 536-5880
Fax
(252) 536-2708
NPI assigned
Oct 20, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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 8812 NC Primary

Addresses

Primary practice location

2064 NC Highway 125
Roanoke Rapids, NC 27870-9436

Mailing address

PO Box 640
Roanoke Rapids, NC 27870-0640
Phone (252) 536-5440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240605003142 NC Practitioner - Dentist 1456654540 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Health Group, Inc. Current Accepting new patients
Twin County Rural Health Center, Inc. Past Accepting new patients

Locations

9425 NC Highway 305
Jackson, NC 27845
Phone (252) 534-1661

1381 Medical Center Dr
Roanoke Rapids, NC 27870
Phone (252) 535-1414

2064 NC Highway 125
Roanoke Rapids, NC 27870
Phone (252) 536-5000

Organizations & group practices 2

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": "1255996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1376879726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278700640",
            "telephone_number": "252-536-5440",
            "fax_number": "252-536-5444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2064 NC HIGHWAY 125",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278709436",
            "telephone_number": "252-536-5880",
            "fax_number": "252-536-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENGLISH-MANGUM",
        "first_name": "DANIELLE",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-20",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

Verify at the official NPI Registry.