Shannen Marie Sandal Manlucu

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2348 Ralph Ave
Brooklyn, NY 11234-5515

Phone

(718) 531-0300

NPI assigned

Apr 3, 2020

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

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.

• Manlucu Dental Group PC

  • General Practice Dentistry
  • Rockville, MD
  • NPI 1336962315
  NPD Authorized official
• Perfect Endo Corp

  • Durable Medical Equipment & Medical Supplies
  • Brooklyn, NY
  • NPI 1356842132
  NPD
• Skyline Dental Partners PLLC

  dba Ralph Avenue Dental

  • General Practice Dentistry
  • Brooklyn, NY
  • NPI 1831663202
  NPD (past)

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1942839725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 55TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112202508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2348 RALPH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345515",
            "telephone_number": "718-531-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 55th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112202508",
            "country_code": "US",
            "telephone_number": "718-630-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANLUCU",
        "first_name": "SHANNEN MARIE",
        "middle_name": "SANDAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "061795",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric Mank, MD
• Remi Mankes
• Elesandel Manlapaz, RN
• Joel Manley, DDS
• Myrl Ray Stephen Manley, M.D.
• Mann Medical, PLLC
• Clement L Mann
• Corey Mann, LMSW
• David Norman Mann, M.D.
• Esther Mann

• Student in an Organized Health Care Education/Training Program in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.