Individual provider Active NPI

Matthew H Maneely, DDS

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1669496824
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8008 Issued in AZ
Practice address
7006 S Central Ave
Phoenix, AZ 85042-5423
Phone
(602) 276-1029
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5590-015 WI
General Practice Dentistry 1223G0001X 8008 AZ Primary

Addresses

Primary practice location

7006 S Central Ave
Phoenix, AZ 85042-5423

Mailing address

7006 S Central Ave
Phoenix, AZ 85042-5423
Phone (602) 276-1029

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
8008AZMDChiropractor
5590-015WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Squaw Peak Anesthesia 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386806400000",
    "number": "1669496824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7006 S CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425423",
            "telephone_number": "602-276-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7006 S CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850425423",
            "telephone_number": "602-276-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANEELY",
        "first_name": "MATTHEW",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "5590-015",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "8008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.