Provider Demographics
NPI:1649215393
Name:CHHEDA, MANISHA RAMESH (DDS)
Entity Type:Individual
Prefix:
First Name:MANISHA
Middle Name:RAMESH
Last Name:CHHEDA
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 1:5320 159TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-4705
Mailing Address - Country:US
Mailing Address - Phone:708-687-3777
Mailing Address - Fax:708-687-4339
Practice Address - Street 1:5320 159TH ST
Practice Address - Street 2:SUITE 500
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-4705
Practice Address - Country:US
Practice Address - Phone:708-687-3777
Practice Address - Fax:708-687-4339
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A15404122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist