Provider Demographics
NPI:1487860722
Name:KEJRIWAL, MANJU RANI (DDS)
Entity Type:Individual
Prefix:DR
First Name:MANJU
Middle Name:RANI
Last Name:KEJRIWAL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7140 MIAMI AVE
Mailing Address - Street 2:SUITE# 102
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45243-2676
Mailing Address - Country:US
Mailing Address - Phone:513-271-5800
Mailing Address - Fax:513-271-5843
Practice Address - Street 1:7140 MIAMI AVE
Practice Address - Street 2:SUITE# 102
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45243-2676
Practice Address - Country:US
Practice Address - Phone:513-271-5800
Practice Address - Fax:513-271-5843
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH19324122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH311505278 029OtherCARESOURCE