Individual provider Active NPI

Adina Manolescu, DDS

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1861407462
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53830 Issued in CA
Practice address
6529 Mission Gorge Rd
San Diego, CA 92120-2306
Phone
(619) 283-3161
Fax
(619) 331-6730
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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 53830 CA Primary

Addresses

Primary practice location

6529 Mission Gorge Rd
San Diego, CA 92120-2306

Mailing address

6529 Mission Gorge Rd
San Diego, CA 92120-2306
Phone (619) 283-3161

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: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170526000343 CA Order and Referring Only - DentistPractitioner - Dentist 2062724594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53830CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1861407462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6529 MISSION GORGE RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202306",
            "telephone_number": "619-283-3161",
            "fax_number": "619-331-6730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6529 MISSION GORGE RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921202306",
            "telephone_number": "619-283-3161",
            "fax_number": "619-331-6730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOLESCU",
        "first_name": "ADINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.