Individual
VIVEK MANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1681 NW 70TH AVE APT 316, PLANTATION, FL 33313-5266
(718) 755-7844
Mailing address
1681 NW 70TH AVE APT 316, PLANTATION, FL 33313-5266
(718) 755-7844
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN28874
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN28874
FLORIDA DENTAL LICENSE NUMBER
FL
Enumeration date
05/14/2024
Last updated
04/27/2026
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