Andrew Benjamin Mancia, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN23921 Issued in FL

Practice address

14444 Beach Blvd Ste 2
Jacksonville, FL 32250-2010

Phone

(904) 223-4939

Fax

(904) 903-4551

NPI assigned

Oct 13, 2021

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1634083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634083200000",
    "number": "1396407730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 TECHNOLOGY PARK STE 101",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327467122",
            "telephone_number": "407-543-8509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14444 BEACH BLVD STE 2",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322502010",
            "telephone_number": "904-223-4939",
            "fax_number": "904-903-4551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCIA",
        "first_name": "ANDREW",
        "middle_name": "BENJAMIN",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-13",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN23921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary R Manasse, D.M.D., P.A.
• Miguel Mancao III
• Lynda R. Mance, L.C.S.W., CEAP, SAP
• Alisha M Mancebo
• Clarissa Mancheno, CRNA
• Andrew Mancusi-Ungaro, M.D.
• Melissa Snyder Mancuso, M.D.
• Akhila Reddy Mandadi, M.D.
• Sunny Mandal, DO
• Mandarin Chiropractic Center PA

• Orthodontics and Dentofacial Orthopedics Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.