Provider Demographics
NPI:1235161860
Name:VORA, MAYANK D (DDS)
Entity Type:Individual
Prefix:
First Name:MAYANK
Middle Name:D
Last Name:VORA
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 1:6251 GRAND RIVER RD STE 600
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-5321
Mailing Address - Country:US
Mailing Address - Phone:517-552-2000
Mailing Address - Fax:175-552-2885
Practice Address - Street 1:6251 GRAND RIVER RD STE 600
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-5321
Practice Address - Country:US
Practice Address - Phone:517-552-2000
Practice Address - Fax:175-552-2885
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010185901223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics