Provider Demographics
NPI:1609047596
Name:MANKAME, DIPAK MEGHNATH (DDS)
Entity Type:Individual
Prefix:DR
First Name:DIPAK
Middle Name:MEGHNATH
Last Name:MANKAME
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:MRS
Other - First Name:MANKAME
Other - Middle Name:DIPAK
Other - Last Name:M DDS.,PA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:300 NW 70TH AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2384
Mailing Address - Country:US
Mailing Address - Phone:954-791-1630
Mailing Address - Fax:954-327-7450
Practice Address - Street 1:300 NW 70TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2384
Practice Address - Country:US
Practice Address - Phone:954-791-1630
Practice Address - Fax:954-327-7450
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN8570122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist