Provider Demographics
NPI:1780849695
Name:MANKODI, SEEMA (DDS)
Entity Type:Individual
Prefix:
First Name:SEEMA
Middle Name:
Last Name:MANKODI
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 1:6336 BANDERA RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1604
Mailing Address - Country:US
Mailing Address - Phone:210-681-5555
Mailing Address - Fax:210-681-7121
Practice Address - Street 1:6336 BANDERA RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1604
Practice Address - Country:US
Practice Address - Phone:210-681-5555
Practice Address - Fax:210-681-7121
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice