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SMILES FOR MILES DENTAL OFFICE OF DR MANOSOV P.C NPI 1225169683


NPI Information

NPI: 1225169683
Provider Name: SMILES FOR MILES, DENTAL OFFICE OF DR MANOSOV P.C

Doing Business As: SMILES FOR MILES

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
2020 COFFEE RD STE E
MODESTO, CA
ZIP 95355
Phone: (209) 571-9855
Get Directions

SMILES FOR MILES, DENTAL OFFICE OF DR MANOSOV P.C is a general practice dentist in Modesto, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SMILES FOR MILES, DENTAL OFFICE OF DR MANOSOV P.C NPI is 1225169683. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Smiles For Miles.

The provider's business location address is:

2020 COFFEE RD STE E
MODESTO, CA
ZIP 95355-427
Phone: (209) 571-9855
Fax: (209) 571-9874

The provider's authorized official is Lea Manosov .
The authorized official title is Owner and has the following contact phone number (209) 571-9855.

The enumeration date for this NPI number is 3/8/2007 and was last updated on 1/22/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice48326CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G92664-01OTHERCALIFORNIADENTI-CAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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