Henriette Mambe Tago, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

004924 Issued in OH

Practice address

1044 Belmont Ave
Youngstown, OH 44504-1006

Phone

(330) 746-7211

NPI assigned

May 6, 2025

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1982493813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BARBARA LN UNIT 83",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891835860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041006",
            "telephone_number": "330-746-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAMBE TAGO",
        "first_name": "HENRIETTE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "004924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Malmisur, B.A.
• Kacie Malmsberry, COTA/L,
• Kayla R Malone, RN
• Madisyn Mackenzy Maloney, PA-C
• Joseph Michael Malys, DDS
• Gregory Mammone, LPN
• Sherri Ann Mamounis, PCA
• Allison Mancuso
• Michelle Mangine
• Chitsimran Mann

• General Practice Dentistry in Youngstown, OH
• Providers in Youngstown, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.