Provider Demographics
NPI:1386710911
Name:MANII, SIMIN (DMD)
Entity type:Individual
Prefix:
First Name:SIMIN
Middle Name:
Last Name:MANII
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 WHITEHORSE AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08610
Mailing Address - Country:US
Mailing Address - Phone:609-585-1011
Mailing Address - Fax:609-585-1046
Practice Address - Street 1:445 WHITEHORSE AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08610
Practice Address - Country:US
Practice Address - Phone:609-585-1011
Practice Address - Fax:609-585-1046
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI017882001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice