NPIMap

Organization Active NPI

Manchester Walk in Dental Clinic PC

  • General Practice Dentistry
  • Manchester, NH
National Provider Identifier
1598058968
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
03824 Issued in NH
Legal business name
MANCHESTER WALK IN DENTAL CLINIC PC
Practice address
25 S Maple St
Manchester, NH 03103-5738
Phone
(603) 703-0220
Fax
(603) 703-0221
NPI assigned
May 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Authorized official

Name
Dr. Diaa M Mahaba, DMD
Title
President
Phone
(603) 703-0220

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 03824 NH Primary

Addresses

Primary practice location

25 S Maple St
Manchester, NH 03103-5738

Mailing address

25 S Maple St
Manchester, NH 03103-5738
Phone (603) 703-0220

Other names 1

  • NH Walk In Dental Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1305676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305676800000",
    "number": "1598058968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 S MAPLE ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035738",
            "telephone_number": "603-703-0220",
            "fax_number": "603-703-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S MAPLE ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035738",
            "telephone_number": "603-703-0220",
            "fax_number": "603-703-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANCHESTER WALK IN DENTAL CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-18",
        "last_updated": "2011-05-18",
        "status": "A",
        "authorized_official_last_name": "MAHABA",
        "authorized_official_first_name": "DIAA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "603-703-0220",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "03824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NH Walk In Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; 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.