Provider Demographics
NPI:1679169460
Name:MANN, AKSHITA (BDS, MDS, MSD)
Entity Type:Individual
Prefix:DR
First Name:AKSHITA
Middle Name:
Last Name:MANN
Suffix:
Gender:F
Credentials:BDS, MDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 SAGE RD APT 1325
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-6323
Mailing Address - Country:US
Mailing Address - Phone:737-222-3664
Mailing Address - Fax:
Practice Address - Street 1:3000 SAGE RD APT 1325
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6323
Practice Address - Country:US
Practice Address - Phone:737-222-3664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX369401223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty