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NPI Code Detail

MEDICARE: DR. DAVID J MANEGOLD DMD

MEDICARE: DR. DAVID J MANEGOLD DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist30022514OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11710333869OTHERGROUP NPI
21730999194OTHERGROUP NPI

General Provider Information

NPI Number : 1134321375
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID J MANEGOLD DMD
Provider Business Mailing Address
First Line : 9215 CINCINNATI COLUMBUS RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45069
Country : US
Telephone Number : 513-777-5513
Fax Number :
Provider Business Practice Location Address
First Line : 9215 CINCINNATI COLUMBUS RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45069
Country : US
Telephone Number : 513-777-5513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2007
Last Update Date : 01/09/2025

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