Active NPI
Melissa E Mani, DDS
- Dentist
- El Centro, CA
National Provider Identifier
1548212509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 37992
- Practice address
- 1502 S la Brucherie Rd
El Centro, CA 92243-9676 - Phone
- (760) 482-5505
- Fax
- (760) 482-5501
- NPI assigned
- May 17, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 37992 | CA | Primary |
Addresses
Primary practice location
1502 S la Brucherie Rd
El Centro, CA 92243-9676
Mailing address
1452 S la Brucherie Rd
Ste B
El Centro, CA 92243-9676
Phone (760) 482-5505
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D37992 | Medicaid | CA | |
| B37992 | Other | CA | HEALTHY FAMILIES PROG |
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 |
|---|---|---|---|
| 37992 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Dental Group | Past | Accepting new patients | |
| Javad Aghaloo DDS a Professional Corporation | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Southwest Dental Group
- Public Health Dentistry
- El Centro, CA
- NPI 1245606789
-
- General Practice Dentistry
- El Centro, CA
- NPI 1134376551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548212509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1452 S LA BRUCHERIE RD",
"address_2": "STE B",
"city": "EL CENTRO",
"state": "CA",
"postal_code": "922439676",
"telephone_number": "760-482-5505",
"fax_number": "760-482-5501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 S LA BRUCHERIE RD",
"city": "EL CENTRO",
"state": "CA",
"postal_code": "922439676",
"telephone_number": "760-482-5505",
"fax_number": "760-482-5501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANI",
"first_name": "MELISSA",
"middle_name": "E",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "37992",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D37992",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY FAMILIES PROG",
"identifier": "B37992",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in El Centro, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.