MEDICARE: PALAK HITENBHAI MANIAR

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	1223G0001X	General Practice Dentistry	14415	NC

General Provider Information

NPI Number	:	1841175502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PALAK HITENBHAI MANIAR

Provider Business Mailing Address
First Line	:	2717 ADDLESTONE CIR
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27265-8446
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1472 JAG BRANCH BLVD
Second Line	:
City	:	KERNERSVILLE
State	:	NC
Zip	:	27284-6956
Country	:	US
Telephone Number	:	336-571-4339
Fax Number	:

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

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	04/24/2026

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