Suryadeep Singh Mankatala | San Diego, CA • PECOS Search

Suryadeep Singh Mankatala

Dentist

Dental Providers

4731 Clairemont Dr Ste 101, San Diego, CA 92117-2743

PECOS Enrollment

Based on the most recent information from CMS, provider Suryadeep Singh Mankatala does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1962103978
Provider Type
Individual
Full Name
Mankatala, Suryadeep Singh
Title
Dr.
Credential
DDS

Gender
Male
Sole Proprietor
No
Enumeration Date
3/15/2023
Last Updated
7/11/2025

Contact Information

Practice Location

4731 Clairemont Dr Ste 101, San Diego, CA 92117-2743

Unlisted Fax

Mailing Location

1147 Bellingham Dr, Oceanside, CA 92057-2736

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 122300000X Primary	Description Dentist Dental Providers	License 108047 California