Individual provider Active NPI

Janet E Mangum, DMD

  • General Practice Dentistry
  • Mint Hill, NC
National Provider Identifier
1457764458
Registry record updated Aug 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9979 Issued in NC
Practice address
7201 Lebanon Rd
Mint Hill, NC 28227-9232
Phone
(704) 545-3363
Fax
(704) 545-0446
NPI assigned
Jun 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2022

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 9979 NC Primary

Addresses

Primary practice location

7201 Lebanon Rd
Mint Hill, NC 28227-9232

Mailing address

7201 Lebanon Rd
Mint Hill, NC 28227-9232
Phone (704) 545-3363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9979NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Theodore H. Morris Jr DDS. PLLC General Practice CurrentSince Sep 4, 2022 Accepting new patients

Locations

7215 Lebanon Rd
Ste G
Mint Hill, NC 28227
Phone (704) 545-3363

7201 Lebanon Rd
Mint Hill, NC 28227
Phone (704) 545-3363

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661817600000",
    "number": "1457764458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7201 LEBANON RD",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279232",
            "telephone_number": "704-545-3363",
            "fax_number": "704-545-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7201 LEBANON RD",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279232",
            "telephone_number": "704-545-3363",
            "fax_number": "704-545-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGUM",
        "first_name": "JANET",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-06",
        "last_updated": "2022-08-30",
        "certification_date": "2022-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mint Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2022; 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.