Lea Manosov, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

48326 Issued in CA

Practice address

2020 Coffee Rd
Ste E
Modesto, CA 95385-2421

Phone

(209) 571-9855

Fax

(209) 571-9874

NPI assigned

Aug 21, 2006

Last updated

Jan 13, 2021By the provider in NPPES

Sex

Female

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

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.

Opted out of Medicare

Yes, effective Apr 12, 2023 through Apr 12, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Smiles for Miles, Dental Office of Dr Manosov P.C

  dba Smiles for miles

  • General Practice Dentistry
  • Modesto, CA
  • NPI 1225169683
  NPD Authorized official

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610496000000",
    "number": "1407961089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 COFFEE RD",
            "address_2": "STE E",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953852421",
            "telephone_number": "209-571-9855",
            "fax_number": "209-571-9874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 COFFEE RD",
            "address_2": "STE E",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953852421",
            "telephone_number": "209-571-9855",
            "fax_number": "209-571-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOSOV",
        "first_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2021-01-13",
        "certification_date": "2021-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gurdeep Mann, DNP, FNP-C
• Linda Susan Mann, PHN
• Surjit Mann
• Sasi Kala Mannem, D.D.S.
• Arun Manoharan, MD
• Liran Manosov, DDS
• Moran Manosov
• Madison Jonna Manrique
• Angel Manriquez
• Jhonatan Manriquez

• Dentist in Modesto, CA
• Providers in Modesto, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.