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General NPI Number Information
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NPI Number | 1710542618
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Entity Type | Individual
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Provider Name | SRISHTI MANOCHA DDS, MPH
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Gender | Female
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 01/15/2021
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Provider Practice Location Address
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Address Line | 13825 HIGHWAY 59 STE C
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City | SPLENDORA
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State | TX
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Zip | 77372-4837
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Country | US
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Telephone | 281-689-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 4855 MAGNOLIA COVE DR APT 319
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City | KINGWOOD
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State | TX
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Zip | 77345-2292
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Country | US
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Telephone | 713-505-7848
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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 | 103661
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 35699
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License Number State | TX
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