Manogna Deepthi Yakasiri

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12014048A Issued in IN

Practice address

2001 E Broadway
Logansport, IN 46947-2048

Phone

(574) 232-9501

NPI assigned

Aug 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Roy D. Bower, DMD, LLC

  • Dentist
  • Mount Vernon, IL
  • NPI 1841682549
  NPD (past)

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778025600000",
    "number": "1659927515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 WARWICK LN",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628642344",
            "telephone_number": "270-972-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 E BROADWAY",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469472048",
            "telephone_number": "574-232-9501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Broadway St Ste C",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "IL",
            "postal_code": "628642282",
            "country_code": "US",
            "telephone_number": "618-241-0353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAKASIRI",
        "first_name": "MANOGNA",
        "middle_name": "DEEPTHI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12014048A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Witmer
• Brittany Nichole Wolfe, OD
• Jordan Elise Wood, NP
• Angela Woolever, M.N.T.
• Michell Worthington, BA
• Jennifer E Yocum, PHARMD
• Amy L Yoder, MA, LMHC
• Young Men'S Christian Association of Cass County, Inc.
• Robin E Young, PSYD
• Angela Zeck, RN

• General Practice Dentistry in Logansport, IN
• Providers in Logansport, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.