Provider Demographics
NPI:1154944254
Name:MANN, RANJEET (DDS)
Entity type:Individual
Prefix:DR
First Name:RANJEET
Middle Name:
Last Name:MANN
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 1:4100 FOREST PARK AVE APT 225
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63108-2889
Mailing Address - Country:US
Mailing Address - Phone:925-998-7214
Mailing Address - Fax:
Practice Address - Street 1:1200 BIG BILL RD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-2117
Practice Address - Country:US
Practice Address - Phone:636-287-0001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-22
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20200135451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice