Provider Demographics
NPI:1710542618
Name:MANOCHA, SRISHTI (DDS, MPH)
Entity Type:Individual
Prefix:DR
First Name:SRISHTI
Middle Name:
Last Name:MANOCHA
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4855 MAGNOLIA COVE DR APT 319
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-2292
Mailing Address - Country:US
Mailing Address - Phone:713-505-7848
Mailing Address - Fax:
Practice Address - Street 1:13825 HIGHWAY 59 STE C
Practice Address - Street 2:
Practice Address - City:SPLENDORA
Practice Address - State:TX
Practice Address - Zip Code:77372-4837
Practice Address - Country:US
Practice Address - Phone:281-689-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103661122300000X
TX35699122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist