Provider Demographics
NPI:1609302207
Name:MANSKI, ALYSSA GAIL (MD, DDS)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:GAIL
Last Name:MANSKI
Suffix:
Gender:F
Credentials:MD, DDS
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:GAIL
Other - Last Name:FLASHBURG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, DDS
Mailing Address - Street 1:500 KNIGHTS RUN AVE UNIT 1405
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-6014
Mailing Address - Country:US
Mailing Address - Phone:732-859-5975
Mailing Address - Fax:
Practice Address - Street 1:4200 N ARMENIA AVE STE 3
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6451
Practice Address - Country:US
Practice Address - Phone:813-870-6000
Practice Address - Fax:215-923-9189
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-03
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0413751223S0112X
390200000X
FL161479204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program