Provider Demographics
NPI:1942254016
Name:MANEA, MADALINA MARINA (DDS)
Entity type:Individual
Prefix:MS
First Name:MADALINA
Middle Name:MARINA
Last Name:MANEA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 MAKAHIKI WAY
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2896
Mailing Address - Country:US
Mailing Address - Phone:808-537-8369
Mailing Address - Fax:808-664-8736
Practice Address - Street 1:935 MAKAHIKI WAY
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2896
Practice Address - Country:US
Practice Address - Phone:808-537-8369
Practice Address - Fax:808-664-8736
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-21
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HICSDT-111-01223D0001X
NY0510001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223D0001XDental ProvidersDentistDental Public Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02511053Medicaid