Brett Gerald Mandich, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DT2449 Issued in HI

Practice address

735 Bishop St Ste 333
Honolulu, HI 96813-4823

Phone

(808) 524-0444

Fax

(808) 524-0456

NPI assigned

Aug 10, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 22, 2017 through May 22, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ala Moana Dental Care, Inc.

  • General Practice Dentistry
  • Honolulu, HI
  • NPI 1851663033
  NPD (past)
• Finn T. Esrason, D.M.D., P.C.

  • Dentist
  • Honolulu, HI
  • NPI 1588009922
  NPD (past)

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312934400000",
    "number": "1730468554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 BISHOP ST STE 333",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134823",
            "telephone_number": "808-524-0444",
            "fax_number": "808-524-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 BISHOP ST STE 333",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134823",
            "telephone_number": "808-524-0444",
            "fax_number": "808-524-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDICH",
        "first_name": "BRETT",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-10",
        "last_updated": "2011-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "HI",
            "license": "DT2449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Hong Manayan, MD, MPH
• Dymphna R Manayao
• Mandala Integrative Therapy, LLC
• Mandalay Clinic LLC
• Jason Liang Mandap, FNP-C
• Maureen A. Mandich, LCSW
• Mindy Lin Mandich, D.O.
• Matthew Alan Mandzik, CRNA
• Madalina Marina Manea, DDS
• Jesusa Agudera Maneja

• General Practice Dentistry in Honolulu, HI
• Providers in Honolulu, HI by specialty
• General Practice Dentistry in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.