Bianca Maniscalco

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.035496 Issued in IL

Practice address

2821 Grand Ave
Waukegan, IL 60085-2372

Phone

(847) 662-4400

NPI assigned

Mar 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Dental Experts, LLC

  • General Practice Dentistry
  • Waukegan, IL
  • NPI 1245487792
  NPD (past)

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1740980077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 HARRISON AVE APT 407",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183478",
            "telephone_number": "630-450-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 GRAND AVE",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852372",
            "telephone_number": "847-662-4400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "761 Harrison Ave Apt 407",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021183478",
            "country_code": "US",
            "telephone_number": "630-450-6391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANISCALCO",
        "first_name": "BIANCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ray Mamerow
• Rebecca W Manaloto Deguzman, RN
• Bruce Mandel
• Bindu Mangat, APRN
• Rachelle Manieri, LMT
• Rodrigo Manjarres, MA
• Amber Nicole Manley, MA
• Agatona Villegas Marasigan, RN
• Karina Itzel Marban
• Eugene Carroll Marceron Jr., LCSW

• General Practice Dentistry in Waukegan, IL
• Providers in Waukegan, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.