Perio Doctor LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PERIO DOCTOR LLC

Doing business as

Oasis Perio

Practice address

1312 E Broward Blvd
Fort Lauderdale, FL 33301-2136

Phone

(786) 449-4262

NPI assigned

Apr 26, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Vanessa Lynn Mancuso, DDS,MSDNPI 1649885492

Title

Owner

Phone

(786) 449-4262

Specialties & licenses 1

Addresses

Other names 1

• OASIS PERIO Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vanessa Lynn Mancuso, DDS, MSD

  • Periodontics
  • Fort Lauderdale, FL
  • NPI 1649885492
  NPD Authorized official

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1881440105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 E BROWARD BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 E BROWARD BLVD",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333012136",
            "telephone_number": "786-449-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIO DOCTOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "MANCUSO",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-449-4262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,MSD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OASIS PERIO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Perform Bty Inc
• Performance Orthopaedic
• Performance Orthopaedics of Florida, LLC
• Performance Rehab, Inc
• Performance Surgical LLC
• Suzanne Perkins
• Ann Perley, PT
• David Edward Perloff, MD
• Raquel Pernas, BCBA
• Madeline Virginia Pernell Adomaitis

• Periodontics in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Periodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.