NPIMap

Organization Active NPI

Praveen Mandera DMD PC

Doing business as New Hampshire Family Dentistry

  • General Practice Dentistry
  • Manchester, NH
National Provider Identifier
1861882375
Registry record updated Feb 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3679 Issued in NH
Legal business name
PRAVEEN MANDERA DMD PC
Doing business as
New Hampshire Family Dentistry
Practice address
2626 Brown Ave
Manchester, NH 03103-6806
Phone
(603) 625-1877
Fax
(603) 647-8719
NPI assigned
Feb 4, 2015
Last updated
Feb 4, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2015

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

Authorized official

Name
Dr. Praveen Kumar Mandera Govindaiah, DMD MHANPI 1699938290
Title
Dentist/Owner
Phone
(781) 526-1496

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3679 NH Primary

Addresses

Primary practice location

2626 Brown Ave
Manchester, NH 03103-6806

Mailing address

2626 Brown Ave
Manchester, NH 03103-6806
Phone (603) 625-1877

Other names 1

  • NEW HAMPSHIRE FAMILY DENTISTRY Doing business as

National Provider Directory

National Provider Directory

Locations

2626 Brown Ave
Manchester, NH 03103
Phone (603) 625-1877

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423008000000",
    "number": "1861882375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 BROWN AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031036806",
            "telephone_number": "603-625-1877",
            "fax_number": "603-647-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 BROWN AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031036806",
            "telephone_number": "603-625-1877",
            "fax_number": "603-647-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAVEEN MANDERA DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-02-04",
        "status": "A",
        "authorized_official_last_name": "MANDERA GOVINDAIAH",
        "authorized_official_first_name": "PRAVEEN KUMAR",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "781-526-1496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD MHA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "3679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEW HAMPSHIRE FAMILY DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Manchester, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2015; 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.