Vanessa Lynn Mancuso, DDS, MSD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DN25475 Issued in FL

Practice address

1312 E Broward Blvd
Fort Lauderdale, FL 33301-2136

Phone

(786) 449-4262

NPI assigned

Sep 9, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Vanessa Lynn Mancuso Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Perio Doctor LLC

  • Periodontics
  • Fort Lauderdale, FL
  • NPI 1881440105
  NPD Authorized official

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1649885492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 E BROWARD BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012136",
            "telephone_number": "786-449-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 E BROWARD BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012136",
            "telephone_number": "786-449-4262"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 S US Highway 1 Ste 250",
            "address_purpose": "LOCATION",
            "city": "Jupiter",
            "state": "FL",
            "postal_code": "334775193",
            "country_code": "US",
            "telephone_number": "786-449-4262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCUSO",
        "first_name": "VANESSA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "FL",
            "license": "DN25475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "MANCUSO",
            "middle_name": "LYNN",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Managed Healthcare Systems, Inc
• Janis Manalang, L.P.C. LHMC
• Eli Manata Sloan
• Arnol Miguel Mancera Sanchez, SA-C
• Mayerli Alejandra Mancia, BEHAVIOR TECHNICIAN
• Jeffrey D Mandelkorn
• Barbara Mandrisch, OT
• Anele Ramia Manfredini, M.D.
• Stephen James Mangan, DMD
• Monique Lenore Manganelli, MD

• Periodontics in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.