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General NPI Number Information
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NPI Number | 1346762507
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Entity Type | Individual
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Provider Name | MANISHA DHANANJAYA DDS
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Gender | Female
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 10630 LITTLE PATUXENT PKWY STE 410
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City | COLUMBIA
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State | MD
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Zip | 21044
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Country | US
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Telephone | 410-346-2350
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Fax |
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Provider Business Mailing Address
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Address Line | 10114 CENTURY DR
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City | ELLICOTT CITY
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State | MD
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Zip | 21042-6247
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Country | US
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Telephone | 484-999-1169
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1857682
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2901023206
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN1857682
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 17570
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License Number State | MD
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