Kevin Lloyd Mansell, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5597760-9922 Issued in UT

Practice address

1030 E 11400 S
Suite 102
Sandy, UT 84094-6902

Phone

(801) 572-2250

Fax

(801) 572-2337

NPI assigned

Mar 26, 2007

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

Enrolled in TX

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.

Enrollment records 1

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.

• Mansell Family Dentistry & Orthodontics

  • Dental Clinic/Center
  • Northlake, TX
  • NPI 1225502958
  NPD (past) Authorized official

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760500110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E 11400 S",
            "address_2": "SUITE 102",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840946902",
            "telephone_number": "801-572-2250",
            "fax_number": "801-572-2337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E 11400 S",
            "address_2": "SUITE 102",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840946902",
            "telephone_number": "801-572-2250",
            "fax_number": "801-572-2337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSELL",
        "first_name": "KEVIN",
        "middle_name": "LLOYD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "5597760-9922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renee W. Malae, RN
• Erica Maria Malagon-Blackwell
• Elia Mamea
• Mana Training Consultants, LLC
• Susiane Manning
• Malamamaisaua Manuma
• Moana Manuo
• Marathon Health LLC
• Stephen P Marble, MD
• Donna Mariechild, MA

• Dentist in Sandy, UT
• Providers in Sandy, UT by specialty
• Dentist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.