Ruchin Shaileshkumar Mandiwala, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901022695 Issued in MI

Practice address

4025 E Hill Rd
Grand Blanc, MI 48439-7942

Phone

(810) 695-4300

NPI assigned

Jun 18, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1447744016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 KELLOGG ST APT 63",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 E HILL RD",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484397942",
            "telephone_number": "810-695-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANDIWALA",
        "first_name": "RUCHIN",
        "middle_name": "SHAILESHKUMAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901022695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dominick Malene, DO
• Brendan Mathew Mamon, MD
• Kumar Manam, PT,PHD
• Nancy Mandair, PHARMD
• Mandi Withey, Ms, LLP, PLLC
• James Victor Mangan, LPC
• Jaspreet Mann, M.D.
• Stephen Eugene Manning, DO
• Jason Mansoor
• Maple Specialized Residential Services

• General Practice Dentistry in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.