Individual provider Active NPI

Jose Joel Manalese, DDS

  • General Practice Dentistry
  • Riverside, CA
National Provider Identifier
1770716672
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58729 Issued in CA
Practice address
3950 Pierce St Ste L
Riverside, CA 92505-3809
Phone
(951) 688-0082
Fax
(951) 688-0501
NPI assigned
Aug 26, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 58729 CA Primary

Addresses

Primary practice location

3950 Pierce St Ste L
Riverside, CA 92505-3809

Mailing address

3950 Pierce St Ste L
Riverside, CA 92505-3809
Phone (951) 688-0082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
58729CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jose Joel Manalese DDS Inc PastSince Jul 24, 2022 Accepting new patients
Pierce la Sierra Dental Group Inc General Practice PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1251244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1770716672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 PIERCE ST STE L",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053809",
            "telephone_number": "951-688-0082",
            "fax_number": "951-688-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 PIERCE ST STE L",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053809",
            "telephone_number": "951-688-0082",
            "fax_number": "951-688-0501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALESE",
        "first_name": "JOSE",
        "middle_name": "JOEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.