Mohan, Maneesh

Mohan, Maneesh is an sole proprietor health care provider with primary practice located at 5100 Outer Loop Suite B, Louisville KY 40219-3201. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Mohan, Maneesh can be contacted via phone (502) 966-8660.

Contact Information

Primary practice address
5100 Outer Loop Suite B Louisville KY 40219-3201
Phone: (502) 966-8660
Fax: (502) 969-8444
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 8191 Kentucky
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 12011030A Indiana
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 8181 Kentucky

Profile Details

NPI number 1154310985
LBN Legal business name Mohan, Maneesh
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 14th, 2005
Last updated Jun 12th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154310985 NPPES
Indiana MEDICAID 200872180
Indiana Other 9179239
Indiana MEDICAID 6411381400
Indiana MEDICAID 204E0000X
Indiana Other 50007575

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