Provider Demographics
NPI:1073618740
Name:MANI, ADARSH GIULAB
Entity Type:Individual
Prefix:DR
First Name:ADARSH
Middle Name:GIULAB
Last Name:MANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 NORTH OHIO AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365
Mailing Address - Country:US
Mailing Address - Phone:937-492-4598
Mailing Address - Fax:937-492-7993
Practice Address - Street 1:113 NORTH OHIO AVE
Practice Address - Street 2:STE 310
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365
Practice Address - Country:US
Practice Address - Phone:937-492-4598
Practice Address - Fax:937-492-7993
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH212361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2262895Medicaid