Provider Demographics
NPI:1225768864
Name:MANSURI, SALONI NISARAHMED (DMD)
Entity Type:Individual
Prefix:DR
First Name:SALONI
Middle Name:NISARAHMED
Last Name:MANSURI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1419 W ALLEGHENY AVE APT 601
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19132-1712
Mailing Address - Country:US
Mailing Address - Phone:267-314-4773
Mailing Address - Fax:
Practice Address - Street 1:2031 N BROAD ST STE 141
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1063
Practice Address - Country:US
Practice Address - Phone:215-393-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043690122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist