NPIMap

Organization Active NPI

Mark Mangels, DMD, LLC

  • Periodontics
  • Saint Peters, MO
National Provider Identifier
1497959894
Registry record updated Nov 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
013969 Issued in MO
Legal business name
MARK MANGELS, DMD, LLC
Practice address
1 Mid Rivers Mall Dr
Suite 370
Saint Peters, MO 63376-4320
Phone
(636) 970-0295
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2007

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

Authorized official

Name
Dr. Mark Alan Mangels, DMDNPI 1215945415
Title
Owner
Phone
(636) 970-0295

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 013969 MO Primary

Addresses

Primary practice location

1 Mid Rivers Mall Dr
Suite 370
Saint Peters, MO 63376-4320

Mailing address

1 Mid Rivers Mall Dr
Suite 370
Saint Peters, MO 63376-4320
Phone (636) 970-0295

National Provider Directory

National Provider Directory

Locations

1 Mid Rivers Mall Dr
Ste 370
Saint Peters, MO 63376
Phone (636) 970-0295

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193875200000",
    "number": "1497959894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MID RIVERS MALL DR",
            "address_2": "SUITE 370",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633764320",
            "telephone_number": "636-970-0295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MID RIVERS MALL DR",
            "address_2": "SUITE 370",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633764320",
            "telephone_number": "636-970-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK MANGELS, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2007-11-01",
        "status": "A",
        "authorized_official_last_name": "MANGELS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "636-970-0295",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "013969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2007; 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.