Healthcare Provider Details

I. General information

NPI: 1861302937
Provider Name (Legal Business Name): PARIYA MANIT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 S OAK AVE STE 6
OAKDALE CA
95361-3528
US

IV. Provider business mailing address

190 S OAK AVE STE 6
OAKDALE CA
95361-3528
US

V. Phone/Fax

Practice location:
  • Phone: 209-847-2800
  • Fax: 209-847-2929
Mailing address:
  • Phone: 209-847-2800
  • Fax: 209-847-2929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS113660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: