Individual provider Active NPI

Maria Mangine, DDS

  • General Practice Dentistry
  • Washington, DC
National Provider Identifier
1609438597
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DEN1001978 Issued in DC
Practice address
1426 21St St NW FL 2
Washington, DC 20036-5947
Phone
(202) 331-3476
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401416431 VA
General Practice Dentistry 1223G0001X 16803 MD
General Practice Dentistry 1223G0001X DEN1001978 DC Primary

Addresses

Primary practice location

1426 21St St NW FL 2
Washington, DC 20036-5947

Mailing address

1804 Bay St SE
Washington, DC 20003-2509
Phone (315) 558-2828

Other practice location 1

1363 Beverly Rd Ste 250
Mc Lean, VA 22101-3664
Phone (703) 712-8071

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

LicenseStateTypeSpecialty
DEN1001978DCMDGeneral Practice Dentistry
0401416431VAMDGeneral Practice Dentistry
16803MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1609438597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 BAY ST SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200032509",
            "telephone_number": "315-558-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 21ST ST NW FL 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200365947",
            "telephone_number": "202-331-3476"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1363 Beverly Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221013664",
            "country_code": "US",
            "telephone_number": "703-712-8071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANGINE",
        "first_name": "MARIA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416431",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "16803",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1001978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; 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.