Healthcare Provider Details

I. General information

NPI: 1376757005
Provider Name (Legal Business Name): BEN MANESH DDS III PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 ROCKVILLE PIKE 10
ROCKVILLE MD
20852-1658
US

IV. Provider business mailing address

1750 ROCKVILLE PIKE 10
ROCKVILLE MD
20852-1658
US

V. Phone/Fax

Practice location:
  • Phone: 301-770-5400
  • Fax: 301-770-6642
Mailing address:
  • Phone: 301-770-5400
  • Fax: 301-770-6642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: LAUREN MANDELL
Title or Position: OFFICE MANAGER
Credential:
Phone: 301-770-5400