Provider Demographics
NPI:1518708072
Name:FLEURINORD, MANOUCHKA (DDS)
Entity type:Individual
Prefix:
First Name:MANOUCHKA
Middle Name:
Last Name:FLEURINORD
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 1:1777 PEACHTREE ST NE UNIT 713
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2380
Mailing Address - Country:US
Mailing Address - Phone:786-509-3882
Mailing Address - Fax:
Practice Address - Street 1:4718 ASHFORD DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-5576
Practice Address - Country:US
Practice Address - Phone:770-625-1968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29034122300000X
DCDEN2000414122300000X
GADN123453122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist