Provider Demographics
NPI:1427928258
Name:SRIJANANI MANOHAR, DMD, ASSOCIATES, INC
Entity type:Organization
Organization Name:SRIJANANI MANOHAR, DMD, ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SRIJANANI
Authorized Official - Middle Name:
Authorized Official - Last Name:MANOHAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:707-623-7477
Mailing Address - Street 1:1325 OLIVER RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94534-3470
Mailing Address - Country:US
Mailing Address - Phone:707-675-0826
Mailing Address - Fax:
Practice Address - Street 1:1325 OLIVER RD
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-3470
Practice Address - Country:US
Practice Address - Phone:707-675-0826
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty