Provider Demographics
NPI:1184006157
Name:DAKERMANJI, THOMAS (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:DAKERMANJI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ARCH ST STE 303
Mailing Address - Street 2:DENTAL CLINIC
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1432
Mailing Address - Country:US
Mailing Address - Phone:240-277-7217
Mailing Address - Fax:
Practice Address - Street 1:75 ARCH ST STE 303
Practice Address - Street 2:DENTAL CLINIC
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1432
Practice Address - Country:US
Practice Address - Phone:240-277-7217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRES.35731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice