Gary R Manasse DMD PA

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN13435 Issued in FL

Legal business name

GARY R MANASSE DMD PA

Practice address

8708 Perimeter Park Blvd
#3
Jacksonville, FL 32216

Phone

(904) 646-1414

Fax

(904) 646-1454

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Gary R Manasse, DMDNPI 1023351152

Title

Owner

Phone

(904) 646-1414

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gary R Manasse, D.M.D., P.A.

  • Endodontics
  • Jacksonville, FL
  • NPI 1023351152
  NPD (past) Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992804595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8708 PERIMETER PARK BLVD",
            "address_2": "#3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-646-1414",
            "fax_number": "904-646-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8708 PERIMETER PARK BLVD",
            "address_2": "#3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32216",
            "telephone_number": "904-646-1414",
            "fax_number": "904-646-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY R MANASSE DMD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MANASSE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-646-1414",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN13435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gartrell Ministries, Inc.
• Terry D. Gartrell, M.A., RMHCI
• Garvin Family Ventures LLC
• Immanuel Ishmael Garvin, DC
• Kirvona Garvin, BACHELOR LEVEL
• Gary S McCoy DPM PA
• Sha-Londa Gary
• Shadai Gary, FNP-C
• Bret Garza, MD
• Aleisha Michelle Gasaway, APRN FNP

• Endodontics in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Endodontics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.