Individual provider Active NPI

Tiffany Manzoni, D.D.S, M.S.

  • Dentist
  • Chesapeake, VA
National Provider Identifier
1497907976
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401412036 Issued in VA
Practice address
501 Independence Pkwy
Suite 101
Chesapeake, VA 23320-5173
Phone
(757) 467-2102
NPI assigned
Oct 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401412036 VA Primary

Addresses

Primary practice location

501 Independence Pkwy
Suite 101
Chesapeake, VA 23320-5173

Mailing address

501 Independence Pkwy
Suite 101
Chesapeake, VA 23320-5173
Phone (757) 467-2102

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0401412036VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1497907976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 INDEPENDENCE PKWY",
            "address_2": "SUITE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205173",
            "telephone_number": "757-467-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 INDEPENDENCE PKWY",
            "address_2": "SUITE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233205173",
            "telephone_number": "757-467-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZONI",
        "first_name": "TIFFANY",
        "name_prefix": "Dr.",
        "credential": "D.D.S, M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.