Lourdes Alexandra Manibo, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN19387 Issued in FL

Practice address

4800 Lakewood Ranch Blvd
Bradenton, FL 34211-4953

Phone

(941) 405-1600

NPI assigned

Aug 25, 2009

Last updated

Nov 11, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Lourdes Alexandra Manibo Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1730312760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 LAKEWOOD RANCH BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114953",
            "telephone_number": "941-405-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 LAKEWOOD RANCH BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342114953",
            "telephone_number": "941-405-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANIBO",
        "first_name": "LOURDES",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN19387",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "054531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LOURDES",
            "last_name": "MANIBO",
            "middle_name": "ALEXANDRA",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lawrence George Manco, MD
• Alessandra Mancuso
• Mandelblum and Cohen Medical Consultants
• Paula Jean Maness, PSY.D.
• Samantha J Mangino, LGSW
• Gilbert Merto Maningas
• Chezare K Mann
• David Bruce Mann II, DMD
• Sandra Lee Mannon, APRN
• Shenieka Manzi

• General Practice Dentistry in Bradenton, FL
• Providers in Bradenton, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.