JESSE ISAAC MANGELSDORF (NPI# 1982150264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982150264 |
| Entity Type | Individual |
| Full Name | JESSE ISAAC MANGELSDORF |
| Credential | D.D.S. |
| Practice Address |
2249 Hualapai Mountain Rd Suite A Kingman AZ 86401-8321 |
| Mailing Address |
2499 Hualapai Mountain A Kingman AZ 86401 |
| Practice Telephone | 9287182136 |
| Mailing Telephone | 9287182136 |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 9535 | AZ | Dental Providers |
| Street Address |
2249 HUALAPAI MOUNTAIN RD SUITE A |
| City | KINGMAN |
| State | AZ |
| Zip Code | 86401-8321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053858704 | Robert Cole | Nurse Practitioner | 3545 Cheyenne Ave, King,an, AZ 86401 | 2017-01-19 |
| 1710420286 | Acadia Healthcare Inc | Nurse Practitioner | 2699 E Andy Devine, Suite B, Kingman, AZ 86401 | 2016-11-30 |
| 1174079800 | Kenneth Mcadow | Physical Therapist | 2404 Stockton Hill Road, Suite K, Kingman, AZ 86401 | 2016-09-01 |
| 1649659483 | Tracie Hirz | Case Manager/Care Coordinator | 3656 Packsaddle Road, Kingman, AZ 86401 | 2015-05-27 |
| 1548657695 | Chelsea Presbrey | Family Medicine | 2202 N Stockton Hill Rd Ste 100, Kingman, AZ 86401 | 2015-04-15 |
| 1649617226 | Abubakr Abdelmunim Tagelsir Abdelaziz | Internal Medicine | 2501 N Stockton Hill Rd Ste 102, Kingman, AZ 86401 | 2013-05-23 |
| 1205173325 | Patricia Jean Marko | Social Worker | 2002 Stockton Hill Road, Mohave Mental Health Clinic, Inc., Kingman, AZ 86401 | 2013-01-09 |
| 1770835316 | Hae Young Lee | Dentist | 2058 Maya Dr., Kingman, AZ 86401 | 2012-10-05 |
| 1255681623 | Hilary Radler | Specialist/Technologist | 3033 Macdonald, Kingman, AZ 86401 | 2012-09-13 |
| 1477836880 | Goodwill of Northern Arizona | Exclusive Provider Organization | 2369 Airway Avenue, Kingman, AZ 86401 | 2011-09-21 |
| Find all providers in zip 86401 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447865480 | Luke Michael Mangelsdorf | Dentist | 2249 Hualapai Mountain Rd Ste 1, Kingman, AZ 86401-8321 | 2020-09-15 |
| 1336645340 | Just for Kids Dental Group Kingman, Pllc | Dentist | 2401 N Stockton Hill Rd Ste 1, Kingman, AZ 86401-4189 | 2018-03-30 |
| 1821436387 | Clark E Melstrom | Dentist | 4601 Stockton Hill Rd., Kingman, AZ 86409-1759 | 2013-06-06 |
| 1407091440 | Nomaan Tariq | Dentist | 3940 Raymond Ave, Kingman, AZ 86409-0930 | 2008-12-04 |
| 1447415799 | Kelly Marie Bradley | Dentist | 1848 Hope Ave, Suite #2, Kingman, AZ 86401 | 2008-07-25 |
| 1669664553 | Theodore S Kimball IIi | Dentist | 2065 Airway Ave, Suite B, Kingman, AZ 86409-3656 | 2007-08-14 |
| 1275753626 | Tori Sandoval | Dentist | 2535 Hualapai Mountain Rd Ste E, Kingman, AZ 86401-5412 | 2007-04-26 |
| 1205931011 | Gary James Lacaze | Dentist | 1616 Stockton Hill Rd, Kingman, AZ 86401 | 2006-09-14 |
| 1942266846 | Mohave Dental Associates PC | Dentist | 4601 Stockton Hill Road, Kingman, AZ 86409 | 2006-04-21 |
| 1538147236 | Richard E Davis | Dentist | 126 West Ave B, Kingman, KS 67068 | 2006-01-04 |
| Find all providers in KINGMAN | ||||
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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.