Provider Demographics
NPI:1356529085
Name:MANJI, SHEHNAZ M (DDS)
Entity type:Individual
Prefix:MRS
First Name:SHEHNAZ
Middle Name:M
Last Name:MANJI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:SHEHNAZ
Other - Middle Name:M
Other - Last Name:SHIAZI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:5630 N ELDRIDGE PKWY STE 900
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-5644
Mailing Address - Country:US
Mailing Address - Phone:713-466-3700
Mailing Address - Fax:713-466-3609
Practice Address - Street 1:5630 N ELDRIDGE PKWY STE 900
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-5644
Practice Address - Country:US
Practice Address - Phone:713-466-3700
Practice Address - Fax:713-466-3609
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19991122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist