NPIMap

Organization Active NPI

Manente NC, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Greensboro, NC
National Provider Identifier
1700579489
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
MANENTE NC, PC
Practice address
1126 N Church St Ste 100
Greensboro, NC 27401-1035
Phone
(336) 272-3737
NPI assigned
May 30, 2023
Organization subpart
Yes
Parent organization
MANENTE NC PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Casey Lonabocker
Title
VP Operations & Strategy
Phone
(617) 535-3364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

1126 N Church St Ste 100
Greensboro, NC 27401-1035

Mailing address

131 Dartmouth St FL 3
Boston, MA 02116-5297
Phone (617) 665-7241

Other names 1

  • McMillian Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Manente NC PC2 organizations share this tax ID, including this one
Part of
Manente NC PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1685404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1700579489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 DARTMOUTH ST FL 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165297",
            "telephone_number": "617-665-7241",
            "fax_number": "617-665-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N CHURCH ST STE 100",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011035",
            "telephone_number": "336-272-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANENTE NC, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANENTE NC PC",
        "enumeration_date": "2023-05-30",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "LONABOCKER",
        "authorized_official_first_name": "CASEY",
        "authorized_official_title_or_position": "VP OPERATIONS & STRATEGY",
        "authorized_official_telephone_number": "617-535-3364"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McMillian Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "McMillian Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.