Mariya Manova DMD. P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

060.009921 Issued in IL

Legal business name

MARIYA MANOVA DMD. P.C.

Practice address

2746 W Fullerton Ave
Chicago, IL 60647-3059

Phone

(501) 773-1233

NPI assigned

Dec 23, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Mariya Ivanova Manova, DMDNPI 1427239516

Title

President

Phone

(501) 773-1233

Specialties & licenses 1

Addresses

Tax ID family

Mariya Manova DMD PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Mariya Manova DMD, P.C.

  • General Practice Dentistry
  • Chicago, IL
  • NPI 1669610028
  NPD tax ID

Practitioners 1

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

• Mariya Ivanova Manova, DMD

  • Dentist
  • Chicago, IL
  • NPI 1427239516
  NPD (past) Authorized official

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

{
    "created_epoch": "1356220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356220800000",
    "number": "1720324502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MAPLE LN",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605614067",
            "telephone_number": "501-773-1233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2746 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606473059",
            "telephone_number": "501-773-1233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIYA MANOVA DMD. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-23",
        "last_updated": "2012-12-23",
        "status": "A",
        "authorized_official_last_name": "MANOVA",
        "authorized_official_first_name": "MARIYA",
        "authorized_official_middle_name": "IVANOVA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "501-773-1233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "060.009921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jose Manuel Mariscal, D.D.S.
• Melissa Mariscal, MD
• Antoine Marison, CADC
• Maritza Lopez Campos PLLC
• Mariya Manova DMD, P.C.
• Latha Mariyappa, MD
• Prabhavathi Mariyappa, M.D.
• Marjerie M Badilla M.D. S.C.
• Marjorie Mintz Rosenbaum MD LLC
• Mark a Szymanski, DCPC

• Dental Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Dental Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2012; 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.