Tatyana Manyak, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45588 Issued in CA

Practice address

100 S Ellsworth Ave
#208
San Mateo, CA 94401-3939

Phone

(650) 342-9941

NPI assigned

Jul 19, 2006

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 CA

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

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477572501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S ELLSWORTH AVE",
            "address_2": "#208",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013939",
            "telephone_number": "650-342-9941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S ELLSWORTH AVE",
            "address_2": "#208",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013939",
            "telephone_number": "650-342-9941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANYAK",
        "first_name": "TATYANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabriela Manriquez, RADT R1477210822
• Carla Mansfield
• Cassandra Gutierrez Manuel, MSN, APRN, FNP-C
• Romina Manuel
• Julie Manyak, MS, CCC
• Brady George Manz
• Rodolfo Manzanares, PTA
• Julia A Manzano
• Minyang Mao, M.D.
• Jaspreet K Marahar

• General Practice Dentistry in San Mateo, CA
• Providers in San Mateo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.