Individual provider Active NPI

Anguel Nikolov Mantchev, DDS

  • General Practice Dentistry
  • Port Angeles, WA
National Provider Identifier
1790803179
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE9683 Issued in WA
Practice address
806 E 8TH Street
Port Angeles, WA 98362
Phone
(360) 452-7666
Fax
(360) 452-2262
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X DE9683 WA Primary

Addresses

Primary practice location

806 E 8TH Street
Port Angeles, WA 98362

Mailing address

806 E 8TH Street
Port Angeles, WA 98362
Phone (360) 452-7666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20150819007799 WA Order and Referring Only - DentistPractitioner - Dentist 4981919909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE9683WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Angel Mantchev DDS Current Accepting new patients

Locations

806 E 8th St
Port Angeles, WA 98362
Phone (360) 452-7666

Organizations & group practices 1

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790803179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 E 8TH STREET",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "98362",
            "telephone_number": "360-452-7666",
            "fax_number": "360-452-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 E 8TH STREET",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "98362",
            "telephone_number": "360-452-7666",
            "fax_number": "360-452-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANTCHEV",
        "first_name": "ANGUEL",
        "middle_name": "NIKOLOV",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE9683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.