MEDICARE: MANOUCHKA FLEURINORD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN29034	FL
2	122300000X	Dentist	DEN2000414	DC
3	122300000X	Dentist	DN123453	GA

General Provider Information

NPI Number	:	1518708072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANOUCHKA FLEURINORD DDS

Provider Business Mailing Address
First Line	:	1777 PEACHTREE ST NE UNIT 713
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2380
Country	:	US
Telephone Number	:	786-509-3882
Fax Number	:

Provider Business Practice Location Address
First Line	:	4718 ASHFORD DUNWOODY RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-5576
Country	:	US
Telephone Number	:	770-625-1968
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2024
Last Update Date	:	10/29/2025

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