Provider Demographics
NPI:1841374436
Name:MANHEIMER, JEFFREY GILBERT (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:GILBERT
Last Name:MANHEIMER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-2305
Mailing Address - Country:US
Mailing Address - Phone:201-384-2112
Mailing Address - Fax:201-384-0076
Practice Address - Street 1:166 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-2305
Practice Address - Country:US
Practice Address - Phone:201-384-2112
Practice Address - Fax:201-384-0076
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI142961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice