Prodent Dental Lab

Primary specialty

Dental LaboratoryTaxonomy code 292200000X

License

016761 Issued in CA

Legal business name

PRODENT DENTAL LAB

Practice address

3000 Alamo Dr Ste 108
Vacaville, CA 95687-6345

Phone

(707) 655-8824

NPI assigned

Jan 27, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Percival Magpusao Manzano, MDTNPI 1508097700

Title

Lab Technician

Phone

(707) 655-8824

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Percival Magpusao Manzano, DDM

  • Denturist
  • Vacaville, CA
  • NPI 1508097700
  NPD (past) Authorized official

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

{
    "created_epoch": "1264550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264636800000",
    "number": "1477884641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ALAMO DR STE 108",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956876345",
            "telephone_number": "707-655-8824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ALAMO DR STE 108",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956876345",
            "telephone_number": "707-655-8824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODENT DENTAL LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-27",
        "last_updated": "2010-01-28",
        "status": "A",
        "authorized_official_last_name": "MANZANO",
        "authorized_official_first_name": "PERCIVAL",
        "authorized_official_middle_name": "MAGPUSAO",
        "authorized_official_title_or_position": "LAB TECHNICIAN",
        "authorized_official_telephone_number": "707-655-8824",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MDT"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "CA",
            "license": "016761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Prelipceanu, O.D.
• Wayne Eric Pribble, PHD
• Janae Shanae Price
• Stirling C Price, SOCIAL WORKER
• Prison Transition Network
• Miranda Nicole Psaila
• Leola Pulliam, DOULA
• Laurel Purcel
• Don Purcell, MD
• Ivan Rodrigo Kiryluk Putziger, M.D.

• Dental Laboratory in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Dental Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2010; 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.