Individual provider Active NPI

Manuel Joseph Sousa, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Salem, NH
National Provider Identifier
1437284346
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
1509 Issued in NH
Practice address
32 Stiles Rd
Sutie 211
Salem, NH 03079-2892
Phone
(603) 898-4722
Fax
(603) 898-4966
NPI assigned
Feb 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 1509 NH Primary

Addresses

Primary practice location

32 Stiles Rd
Sutie 211
Salem, NH 03079-2892

Mailing address

32 Stiles Rd
Sutie 211
Salem, NH 03079-2892
Phone (603) 898-4722

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20150629001070 NH Order and Referring Only - DentistPractitioner - Dentist 7517279979

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1509NHMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Centre for Orthodontics, Inc. Orthodontics and Dentofacial Orthopedics Past 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": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437284346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 STILES RD",
            "address_2": "SUTIE 211",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792892",
            "telephone_number": "603-898-4722",
            "fax_number": "603-898-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 STILES RD",
            "address_2": "SUTIE 211",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792892",
            "telephone_number": "603-898-4722",
            "fax_number": "603-898-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUSA",
        "first_name": "MANUEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NH",
            "license": "1509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

Verify at the official NPI Registry.