Active NPI
Bryan A Manning, DDS
- Dentist
- Sulphur, LA
National Provider Identifier
1609887884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 5194
- Practice address
- 1910 Maplewood Dr
Sulphur, LA 70663-6006 - Phone
- (337) 625-8787
- Fax
- (337) 625-9835
- NPI assigned
- Aug 11, 2006
- 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 | 5194 | LA | Primary |
Addresses
Primary practice location
1910 Maplewood Dr
Sulphur, LA 70663-6006
Mailing address
1910 Maplewood Dr
Sulphur, LA 70663-6006
Phone (337) 625-8787
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851949 | Medicaid | LA |
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 |
|---|---|---|---|
| 5194 | LA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manning Dental Associates Inc | 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.
-
- General Practice Dentistry
- Sulphur, LA
- NPI 1588677819
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609887884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1910 MAPLEWOOD DR",
"city": "SULPHUR",
"state": "LA",
"postal_code": "706636006",
"telephone_number": "337-625-8787",
"fax_number": "337-625-9835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1910 MAPLEWOOD DR",
"city": "SULPHUR",
"state": "LA",
"postal_code": "706636006",
"telephone_number": "337-625-8787",
"fax_number": "337-625-9835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNING",
"first_name": "BRYAN",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "LA",
"license": "5194",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1851949",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sulphur, LA
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.