NPIMap

Organization Active NPI

Riverside Dental LLC

  • General Practice Dentistry
  • West Springfield, MA
National Provider Identifier
1689012361
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1855134 Issued in MA
Legal business name
RIVERSIDE DENTAL LLC
Practice address
235B Memorial Avenue
West Springfield, MA 01028-2846
Phone
(603) 738-6808
Fax
(413) 285-8146
NPI assigned
Jun 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Authorized official

Name
Chandra Mohan Manish, DMDNPI 1821224064
Title
Owner
Phone
(603) 738-6808

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN1855134 MA Primary

Addresses

Primary practice location

235B Memorial Avenue
West Springfield, MA 01028-2846

Mailing address

235B Memorial Avenue
West Springfield, MA 01028-2846
Phone (603) 738-6808

National Provider Directory

National Provider Directory

Locations

235B Memorial Ave
West Springfield, MA 01089
Phone (413) 285-8146

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427673600000",
    "number": "1689012361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235B MEMORIAL AVENUE",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010282846",
            "telephone_number": "603-738-6808",
            "fax_number": "413-285-8146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235B MEMORIAL AVENUE",
            "city": "WEST SPRINGFIELD",
            "state": "MA",
            "postal_code": "010282846",
            "telephone_number": "603-738-6808",
            "fax_number": "413-285-8146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-04",
        "last_updated": "2015-03-30",
        "status": "A",
        "authorized_official_last_name": "MANISH",
        "authorized_official_first_name": "CHANDRA MOHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "603-738-6808",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1855134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; 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.