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General NPI Number Information
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NPI Number | 1730665910
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Entity Type | Individual
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Provider Name | MANASI G VASAVADA DDS
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Gender | Female
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 5900 E VIRGINIA BEACH BLVD
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City | NORFOLK
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State | VA
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Zip | 23502-2530
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Country | US
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Telephone | 757-978-2177
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Fax |
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Provider Business Mailing Address
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Address Line | 3011 GATEWAY DR APT 302
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City | SUFFOLK
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State | VA
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Zip | 23435-1143
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Country | US
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Telephone | 734-239-5711
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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 | 2DI02723400
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License Number State | NJ
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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 | 0401417130
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License Number State | VA
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