Pooja Naginroy Mandalia, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12012357A Issued in IN

Practice address

3611 W 16TH St
Indianapolis, IN 46222-2501

Phone

(734) 369-7371

NPI assigned

Jul 6, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

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.

• Fountain Square Westend Dental LLC

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1639680838
  NPD Authorized official
• Sherman Westend Dental LLC

  • General Practice Dentistry
  • Indianapolis, IN
  • NPI 1548708860
  NPD (past) Authorized official

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468454400000",
    "number": "1922395474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 WINDBOROUGH",
            "city": "BROWNSBURG",
            "state": "IN",
            "postal_code": "461129341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3611 W 16TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462222501",
            "telephone_number": "734-369-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDALIA",
        "first_name": "POOJA",
        "middle_name": "NAGINROY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-06",
        "last_updated": "2016-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028727",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012357A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Manchak
• Naveen Manchanda, MD
• Shalini K Manchanda, MD
• Brian David Mancke, MD
• Gilford Manco
• Terry Jay Mandel, DO
• Mandelbaum Surgical PC
• Jonathan A Mandelbaum, MD
• Tricia Ann Mandelbaum, M.A., CCC-A
• Shai Y Mandelboim, M.D

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; 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.