Provider Demographics
NPI:1598014573
Name:DHARIA, MANEET MUKESH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MANEET
Middle Name:MUKESH
Last Name:DHARIA
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 1:1360 N SANDBURG TER APT 502
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-7990
Mailing Address - Country:US
Mailing Address - Phone:847-525-9650
Mailing Address - Fax:
Practice Address - Street 1:1360 N SANDBURG TER APT 502
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60610-7990
Practice Address - Country:US
Practice Address - Phone:847-525-9650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-05
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.029121122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist