Provider Demographics
NPI:1114408820
Name:MANAS, MATTHEW PINEDA (DDS)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:PINEDA
Last Name:MANAS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 N NELLIS BLVD TRLR 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-2814
Mailing Address - Country:US
Mailing Address - Phone:334-221-5187
Mailing Address - Fax:
Practice Address - Street 1:2790 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3997
Practice Address - Country:US
Practice Address - Phone:702-919-6206
Practice Address - Fax:775-343-7424
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7122122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist