Individual provider Active NPI

Bella C. Manchandia, D.D.S

  • Dentist
  • Pomona, CA
National Provider Identifier
1780774182
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36877 Issued in CA
Practice address
551 E Holt Ave
Pomona, CA 91767-5623
Phone
(909) 622-8600
Fax
(909) 622-9144
NPI assigned
Oct 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36877 CA Primary

Addresses

Primary practice location

551 E Holt Ave
Pomona, CA 91767-5623

Mailing address

551 E Holt Ave
Pomona, CA 91767-5623
Phone (909) 622-8600

Other identifiers 3

IdentifierTypeStateIssuer
DELTA CARE PMIOtherCA001718
G92146-01OtherCADENTICAL
8172OtherCASAFEGUARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170207001692 CA Order and Referring Only - Other (Non-Physician) 4981987468

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780774182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675623",
            "telephone_number": "909-622-8600",
            "fax_number": "909-622-9144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675623",
            "telephone_number": "909-622-8600",
            "fax_number": "909-622-9144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCHANDIA",
        "first_name": "BELLA",
        "middle_name": "C.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "36877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "001718",
            "identifier": "DELTA CARE PMI",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "G92146-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD",
            "identifier": "8172",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.