Provider Demographics
NPI:1740541267
Name:TALSANIA, MANSI SIDDHARTH (DDS)
Entity type:Individual
Prefix:
First Name:MANSI
Middle Name:SIDDHARTH
Last Name:TALSANIA
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 1:5306 CARNABY ST
Mailing Address - Street 2:APT # 219
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-6907
Mailing Address - Country:US
Mailing Address - Phone:909-575-4435
Mailing Address - Fax:
Practice Address - Street 1:3030 LBJ
Practice Address - Street 2:SUITE 1400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75234-7781
Practice Address - Country:US
Practice Address - Phone:682-747-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA613291223G0001X
TX286881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice