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General NPI Number Information
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NPI Number | 1194439612
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Entity Type | Organization
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Legal Business Name | MANISHA SISODIA, DDS INC.
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 01/09/2023
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Provider Practice Location Address
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Address Line | 1720 E LOS ANGELES AVE STE 210
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City | SIMI VALLEY
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State | CA
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Zip | 93065-2094
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Country | US
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Telephone | 805-527-6755
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 E LOS ANGELES AVE STE 210
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City | SIMI VALLEY
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State | CA
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Zip | 93065-2094
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Country | US
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Telephone | 805-527-6755
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MANISHA SISODIA
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Credential | DDS
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Telephone | 213-595-9757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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