Provider Demographics
NPI:1144513599
Name:RAVINDRA BHAKTI DDS PA
Entity type:Organization
Organization Name:RAVINDRA BHAKTI DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAKTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-725-2598
Mailing Address - Street 1:4603 HIGHWAY 6 N
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-2821
Mailing Address - Country:US
Mailing Address - Phone:281-725-2598
Mailing Address - Fax:
Practice Address - Street 1:4603 HIGHWAY 6 N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2821
Practice Address - Country:US
Practice Address - Phone:281-725-2598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00202441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty