Active NPI
Ci Yen Joanna Man, DDS.
- General Practice Dentistry
- San Francisco, CA
National Provider Identifier
1720602964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 112110
- Practice address
- 79 Liberty St
San Francisco, CA 94110-2318 - Phone
- (647) 984-2226
- NPI assigned
- Jun 3, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| General Practice Dentistry | 1223G0001X | 112110 | CA | Primary |
Addresses
Primary practice location
79 Liberty St
San Francisco, CA 94110-2318
Mailing address
79 Liberty St
San Francisco, CA 94110-2318
Phone (647) 984-2226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251015004455 | CA | Order and Referring Only - Dentist | 6103313887 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755561600000",
"number": "1720602964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "79 LIBERTY ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941102318",
"telephone_number": "647-984-2226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "79 LIBERTY ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941102318",
"telephone_number": "647-984-2226"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAN",
"first_name": "CI YEN",
"middle_name": "JOANNA",
"name_prefix": "Ms.",
"credential": "DDS.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-03",
"last_updated": "2025-08-19",
"certification_date": "2025-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "112110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.