Active NPI
Manohara Welikala, DMD
- Dentist
- Moorpark, CA
National Provider Identifier
1598799199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 49243
- Practice address
- 55 W Los Angeles Ave
Moorpark, CA 93021-1820 - Phone
- (805) 523-3216
- Fax
- (805) 523-9630
- NPI assigned
- Jul 10, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | 49243 | CA | Primary |
Addresses
Primary practice location
55 W Los Angeles Ave
Moorpark, CA 93021-1820
Mailing address
55 W Los Angeles Ave
Moorpark, CA 93021-1820
Phone (805) 523-3216
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G92552-01 | Other | CA | DENTI-CAL |
| B49243 | Other | CA | CALIFORNIA HELTHY FAMILY |
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 |
|---|---|---|---|
| 49243 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M.Welikala DMD., a Professional Corp | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598799199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 W LOS ANGELES AVE",
"city": "MOORPARK",
"state": "CA",
"postal_code": "930211820",
"telephone_number": "805-523-3216",
"fax_number": "805-523-9630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 W LOS ANGELES AVE",
"city": "MOORPARK",
"state": "CA",
"postal_code": "930211820",
"telephone_number": "805-523-3216",
"fax_number": "805-523-9630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELIKALA",
"first_name": "MANOHARA",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "49243",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL",
"identifier": "G92552-01",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA HELTHY FAMILY",
"identifier": "B49243",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moorpark, 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.