Provider Demographics
NPI:1366671927
Name:BEDI, MANIK SINGH (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:MANIK
Middle Name:SINGH
Last Name:BEDI
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17751 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:FL
Mailing Address - Zip Code:33556-1912
Mailing Address - Country:US
Mailing Address - Phone:813-836-7202
Mailing Address - Fax:
Practice Address - Street 1:17751 GUNN HWY
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:FL
Practice Address - Zip Code:33556
Practice Address - Country:US
Practice Address - Phone:813-836-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-03
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN187081223S0112X
FLME1239093208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery