Provider Demographics
NPI:1598992638
Name:MANCHANDA, RITU (DMD)
Entity Type:Individual
Prefix:DR
First Name:RITU
Middle Name:
Last Name:MANCHANDA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:DREXEL HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19026-4221
Mailing Address - Country:US
Mailing Address - Phone:610-446-3990
Mailing Address - Fax:
Practice Address - Street 1:4750 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:DREXEL HILL
Practice Address - State:PA
Practice Address - Zip Code:19026-4221
Practice Address - Country:US
Practice Address - Phone:610-446-3990
Practice Address - Fax:610-446-3991
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS037929122300000X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist