Active NPI
Vincent W Mancuso Jr., DDS
- Pediatric Dentistry
- Windsor Heights, IA
National Provider Identifier
1790746048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 5809
- Practice address
- 1000 73Rd St
Suite 10
Windsor Heights, IA 50311-1321 - Phone
- (515) 223-1298
- Fax
- (515) 223-1959
- NPI assigned
- Mar 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 5809 | IA | Primary |
Addresses
Primary practice location
1000 73Rd St
Suite 10
Windsor Heights, IA 50311-1321
Mailing address
1000 73Rd St
Suite 10
Windsor Heights, IA 50311-1321
Phone (515) 223-1298
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0038372 | Medicaid | IA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5809 | IA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1790746048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 73RD ST",
"address_2": "SUITE 10",
"city": "WINDSOR HEIGHTS",
"state": "IA",
"postal_code": "503111321",
"telephone_number": "515-223-1298",
"fax_number": "515-223-1959"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 73RD ST",
"address_2": "SUITE 10",
"city": "WINDSOR HEIGHTS",
"state": "IA",
"postal_code": "503111321",
"telephone_number": "515-223-1298",
"fax_number": "515-223-1959"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCUSO",
"first_name": "VINCENT",
"middle_name": "W",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-28",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "IA",
"license": "5809",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0038372",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Windsor Heights, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.