Provider Demographics
NPI:1427240316
Name:MANIKTALA, JAYA ARORA (DDS)
Entity type:Individual
Prefix:
First Name:JAYA
Middle Name:ARORA
Last Name:MANIKTALA
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 1:8710 N 30TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68112-1810
Mailing Address - Country:US
Mailing Address - Phone:402-451-7407
Mailing Address - Fax:
Practice Address - Street 1:8710 N 30TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68112-1810
Practice Address - Country:US
Practice Address - Phone:402-451-7407
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6791122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist