Active NPI
Rashee Goyal Mannava, DMD
- Periodontics
- Dayton, OH
National Provider Identifier
1508266552
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 30.025069
- Practice address
- 4300 Linden Ave
Dayton, OH 45432-3022 - Phone
- (937) 259-0072
- NPI assigned
- Aug 27, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 30.025069 | OH | Primary |
Addresses
Primary practice location
4300 Linden Ave
Dayton, OH 45432-3022
Mailing address
4300 Linden Ave
Dayton, OH 43201
Other practice location 1
190 W Park Ave
suite 4
Du Bois, PA 15801-2277
Phone (814) 371-7515
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30.025069 | OH | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1508266552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4300 LINDEN AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "43201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 LINDEN AVE",
"city": "DAYTON",
"state": "OH",
"postal_code": "454323022",
"telephone_number": "937-259-0072"
}
],
"practiceLocations": [
{
"address_1": "190 W Park Ave",
"address_2": "suite 4",
"address_purpose": "LOCATION",
"city": "Du Bois",
"state": "PA",
"postal_code": "158012277",
"country_code": "US",
"telephone_number": "814-371-7515",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANNAVA",
"first_name": "RASHEE",
"middle_name": "GOYAL",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-27",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "OH",
"license": "30.025069",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.