DR. AGISILAOS PETER MANICKAS (NPI# 1134391675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134391675 |
| Entity Type | Individual |
| Full Name | DR. AGISILAOS PETER MANICKAS |
| Credential | D.M.D. |
| Practice Address |
803 Mass Ave Lexington MA 02420-3918 |
| Practice Telephone | 7818628220 |
| Practice Fax Number | 7818623050 |
| Mailing Telephone | 7818628220 |
| Mailing Fax Number | 7818623050 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-03-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
8886 | MA | Dental Providers |
| Street Address |
803 MASS AVE |
| City | LEXINGTON |
| State | MA |
| Zip Code | 02420-3918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487826913 | David Robert Cusanello | Dentist | 803 Mass Ave, Lexington, MA 02420-3918 | 2008-03-25 |
| 1386816817 | Krista Noel Manickas | Dentist | 803 Mass Ave, Lexington, MA 02420-3918 | 2008-03-25 |
| 1205008778 | Lexington Prosthodontics | Dentist | 803 Mass Ave, Lexington, MA 02420-3918 | 2008-03-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568958643 | Kristen Gargiulo | Physical Therapist | 57 Bedord Street, Ste 202, Lexington, MA 02420 | 2018-07-02 |
| 1902311616 | Lindsey Nicole Wilcox | Physical Therapist | 57 Bedford St Ste 202, Lexington, MA 02420 | 2017-12-05 |
| 1629590443 | Jeffrey Phillip Winer | Psychologist | 57 Bedford St Ste 230, Lexington, MA 02420 | 2017-07-13 |
| 1235678178 | Rebecca Munini | Counselor | 76 Bedford Street, Suite 12, Office 1, Lexington, MA 02420 | 2017-02-13 |
| 1700332376 | Aretha Cohen | Speech-Language Pathologist | 840 Emerson Gardens Road, Excel Center, Lexington, MA 02420 | 2016-09-01 |
| 1710387915 | Niravkumar Patel | Internal Medicine | 4 Hadley Rd, Lexington, MA 02420 | 2014-08-26 |
| 1316368749 | Triad Adolescent Services | Counselor | 363 Mass Ave, Suite 204, Lexington, MA 02420 | 2014-01-03 |
| 1447698063 | Emily Flier Matteodo | Psychiatry & Neurology | 35 Bedford Street, Suite #6, Lexington, MA 02420 | 2013-06-05 |
| 1780941914 | Varun Kapur | Surgery | 33 York St, Lexington, MA 02420 | 2012-04-12 |
| 1992091433 | Karolyn Mary Franz | Acupuncturist | 238 Bedford St Ste 5, Lexington, MA 02420 | 2011-06-23 |
| Find all providers in zip 02420 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619446713 | Lexington Implant and Restorative Dentistry | Dentist | 803 Massachusetts Ave, Lexington, MA 02420-3918 | 2018-11-19 |
| 1154818359 | Lexington Smile Studio, PC | Dentist | 922 Waltham St Ste 202, Lexington, MA 02421-8019 | 2018-04-13 |
| 1730502972 | Dan Nathanson | Dentist | 7 Field Rd, Lexington, MA 02421-8014 | 2014-01-23 |
| 1861781031 | Brandon Morris Stapleton | Dentist | 541 Darby Creek Road Ste 190, Lexington, KY 40509-1701 | 2011-03-28 |
| 1487826913 | David Robert Cusanello | Dentist | 803 Mass Ave, Lexington, MA 02420-3918 | 2008-03-25 |
| 1366504417 | Arthur F. Sun | Dentist | 1725 Massachusetts Ave, Lexington, MA 02420-5306 | 2006-12-15 |
| 1760975650 | Identity Dental Studio, Pllc | Dentist | 541 Darby Creek Road, Ste 190, Lexington, KY 40509 | 2018-06-14 |
| 1386816817 | Krista Noel Manickas | Dentist | 803 Mass Ave, Lexington, MA 02420-3918 | 2008-03-25 |
| 1205008778 | Lexington Prosthodontics | Dentist | 803 Mass Ave, Lexington, MA 02420-3918 | 2008-03-25 |
| 1114054525 | James Andrew Chandler | Dentist | 1640 Nicholasville Rd, Suite 202, Lexington, KY 40503-1432 | 2007-02-27 |
| Find all providers in LEXINGTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.