MEDICARE: DR. MANJARI MANOHARAN KULKARNI DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	22DIO2305701	NJ
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS031196L	PA

General Provider Information

NPI Number	:	1255420246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MANJARI MANOHARAN KULKARNI DMD

Provider Business Mailing Address
First Line	:	107 W 75TH ST
Second Line	:	#2B
City	:	NEW YORK
State	:	NY
Zip	:	10023-1816
Country	:	US
Telephone Number	:	412-908-9036
Fax Number	:	212-362-4208

Provider Business Practice Location Address
First Line	:	1720 WASHINGTON RD STE 203
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-1208
Country	:	US
Telephone Number	:	412-409-4444
Fax Number	:	412-774-1543

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/22/2021

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