Cesar Mamani, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

52428 Issued in CA

Practice address

22675 Alessandro Blvd
Moreno Valley, CA 92553-8551

Phone

(951) 571-2300

Fax

(951) 571-2330

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cesar.mamanidds.p1@direct.chsica.nextgenshare.com

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.

• Community Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Bloomington, CA
  • NPI 1952308009
  Medicare reassignment NPD (past)
• Community Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Moreno Valley, CA
  • NPI 1679749501

  General Practice

  NPD
• Indiana University Health Ball Memorial Hospital, Inc.

  • General Acute Care Hospital
  • Muncie, IN
  • NPI 1225195340
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326412800000",
    "number": "1871636845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 S MISSION RD",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920284006",
            "telephone_number": "760-451-2730",
            "fax_number": "760-451-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22675 ALESSANDRO BLVD",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925538551",
            "telephone_number": "951-571-2300",
            "fax_number": "951-571-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMANI",
        "first_name": "CESAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2012-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "52428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACT",
            "identifier": "HAP70275G",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "FHC70275G",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Malek
• Malibu Transportation LLC
• Kristen Audrey Malloy
• Kameelah R Malone
• Sharee L Malone
• Abigail Alyssa Aviles Manahan
• Tyler Manalo
• Ketsuree Maneewong
• Nathalie Saray Manriquez
• Mansfield Professional Medical Corporation

• General Practice Dentistry in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.