Provider Demographics
NPI:1639560725
Name:ROCHELLE MANANGKIL DDS INC.
Entity Type:Organization
Organization Name:ROCHELLE MANANGKIL DDS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANANGKIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-759-1905
Mailing Address - Street 1:120 GREENMEADOW CIR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-7331
Mailing Address - Country:US
Mailing Address - Phone:925-759-1905
Mailing Address - Fax:
Practice Address - Street 1:3417 BROADWAY ST
Practice Address - Street 2:SUITE J-1
Practice Address - City:AMERICAN CANYON
Practice Address - State:CA
Practice Address - Zip Code:94503-1294
Practice Address - Country:US
Practice Address - Phone:925-759-1905
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA596691223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty