Victor M Manon, DDS

Primary specialty

Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X

License

16440 Issued in TX

Practice address

23051 Kingwood Place Dr
BLDG a, Ste 100
Kingwood, TX 77339

Phone

(281) 358-2997

Fax

(281) 358-5632

NPI assigned

Aug 30, 2006

Last updated

Apr 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 7, 2013 through Jun 7, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Oral & Maxillofacial Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Kingwood, TX
  • NPI 1316086465

  Oral and Maxillofacial Surgery

  NPD

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1891805198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23051 KINGWOOD PLACE DR",
            "address_2": "BLDG A, STE 100",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "281-358-2997",
            "fax_number": "281-358-5632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23051 KINGWOOD PLACE DR",
            "address_2": "BLDG A, STE 100",
            "city": "KINGWOOD",
            "state": "TX",
            "postal_code": "77339",
            "telephone_number": "281-358-2997",
            "fax_number": "281-358-5632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANON",
        "first_name": "VICTOR",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "TX",
            "license": "16440",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "16440",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "16440",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Louise T Mann, M.D.
• Shelby Grace Mann, MS
• Vipinder Kaur Mann, DO
• Allana Manning, LMT, MMP
• Diana Brosten Mannschreck, MD
• Yvonne K Maosa, DO
• Caleb Marcy
• Maribel Colon-Torrado DMD, PA
• Devyn C Marin, CST
• Martin Basaldua MD Optimal Health & Wellness Center

• Oral and Maxillofacial Pathology Dentistry in Kingwood, TX
• Providers in Kingwood, TX by specialty
• Oral and Maxillofacial Pathology Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.