Nicole J Manigault, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9791 Issued in NC

Practice address

835 Claremont Center Dr
Elkin, NC 28621-2488

Phone

(336) 835-3337

Fax

(336) 835-1241

NPI assigned

Jul 8, 2014

Last updated

Mar 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

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.

• Nicole J Manigault DDS PLLC

  dba ManiDental Family Practice

  • Dental Clinic/Center
  • Elkin, NC
  • NPI 1699542266
  NPD
• Jim a. Harrell, Jr., D.D.S., PA

  • General Practice Dentistry
  • Elkin, NC
  • NPI 1780863555
  NPD (past)

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1467868653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "835 CLAREMONT CENTER DR",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212488",
            "telephone_number": "336-835-3337",
            "fax_number": "336-835-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 CLAREMONT CENTER DR",
            "city": "ELKIN",
            "state": "NC",
            "postal_code": "286212488",
            "telephone_number": "336-835-3337",
            "fax_number": "336-835-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIGAULT",
        "first_name": "NICOLE",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Douglas Lyday, AGPCNP
• Jessica Lynn Mabe, FNP-BC
• Christopher James Macemore, M.S, LCAS-A
• Joanie Blevins Macemore, PA-C
• Desiree Maclean
• Jennifer Coe Marion, ANP-BC
• Wade Ashley Marion, PA
• Sydney Irene Marshall, MS, RDN, LDN
• William Joseph Martin, DO
• Basel Matalka

• General Practice Dentistry in Elkin, NC
• Providers in Elkin, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.