Donna Mansour

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN24732 Issued in FL

Practice address

212 N Moon Ave
Brandon, FL 33510-4422

Phone

(813) 689-5928

NPI assigned

Apr 15, 2019

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

Enrolled in FL

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

Practice roles

Networks

• Freedom Health HMO Network

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.

• Brandon Modern Dentistry, PA

  • General Practice Dentistry
  • Brandon, FL
  • NPI 1831744655
  NPD (past)
• McAuley Dental

  • Dentist
  • Brandon, FL
  • NPI 1598619561
  NPD (past)
• Walker & Barr, DMD, PLLC

  • General Practice Dentistry
  • Brandon, FL
  • NPI 1144435918
  NPD (past)

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

{
    "created_epoch": "1555286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1992368112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 SAWYER RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342331272",
            "telephone_number": "941-366-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N MOON AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104422",
            "telephone_number": "813-689-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-15",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN24732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faiza Manji, M.D.
• Rebekah Jo Mannschreck, MA CCC-SLP
• Claudya Manresa Romero
• Daniela Manso Gonzalez
• Emileidys Manso
• Cora Mapes, PTA
• Maranatha Home Health, Inc
• Nicolas Jordan Marasco, MA, RBT
• Maravida Brandon MGT LLC
• William Srimuang Marconi

• General Practice Dentistry in Brandon, FL
• Providers in Brandon, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; 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.