Provider Demographics
NPI:1588722821
Name:SAVANI, MANUBHAI JADAVJI (DDS)
Entity type:Individual
Prefix:
First Name:MANUBHAI
Middle Name:JADAVJI
Last Name:SAVANI
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 1:4080 TYLER ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503
Mailing Address - Country:US
Mailing Address - Phone:951-359-0149
Mailing Address - Fax:951-359-6408
Practice Address - Street 1:4080 TYLER ST
Practice Address - Street 2:SUITE D
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503
Practice Address - Country:US
Practice Address - Phone:951-359-0149
Practice Address - Fax:951-359-6408
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28980122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA51989OtherSAFEGARD
CA82898001Medicaid
CA207301OtherDELTA CARE PHI