Provider Demographics
NPI:1598921728
Name:GERA, AKANKSHA MANCHANDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:AKANKSHA
Middle Name:MANCHANDA
Last Name:GERA
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 1:60 MADISON AVE
Mailing Address - Street 2:5TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1600
Mailing Address - Country:US
Mailing Address - Phone:212-545-2439
Mailing Address - Fax:646-312-0481
Practice Address - Street 1:9704 SUTPHIN BLVD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-4721
Practice Address - Country:US
Practice Address - Phone:718-657-7088
Practice Address - Fax:718-657-7092
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053993122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
NY03189526Medicaid
NY331978Medicare Oscar/Certification
NY03189526Medicaid
NY331945Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NYG100000410Medicare PIN