Active NPI
Lina Lena Mandybur, D.D.S.
- Dentist
- Cincinnati, OH
National Provider Identifier
1962425827
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 40063
- Practice address
- 8471 Wetherfield LN
Cincinnati, OH 45236-2249 - Phone
- (513) 521-0461
- Fax
- (513) 487-6660
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 40063 | CA | Primary |
Addresses
Primary practice location
8471 Wetherfield LN
Cincinnati, OH 45236-2249
Mailing address
8471 Wetherfield LN
Cincinnati, OH 45236-2249
Phone (513) 521-0461
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40063 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962425827",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8471 WETHERFIELD LN",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452362249",
"telephone_number": "513-521-0461",
"fax_number": "513-487-6660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8471 WETHERFIELD LN",
"city": "CINCINNATI",
"state": "OH",
"postal_code": "452362249",
"telephone_number": "513-521-0461",
"fax_number": "513-487-6660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDYBUR",
"first_name": "LINA",
"middle_name": "LENA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "40063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cincinnati, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.