Provider Demographics
NPI:1720822745
Name:SHETTY&BHATIA DENTAL GROUP,INC
Entity type:Organization
Organization Name:SHETTY&BHATIA DENTAL GROUP,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPAK
Authorized Official - Middle Name:H
Authorized Official - Last Name:SHETTY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-225-6815
Mailing Address - Street 1:5710 CAHALAN AVE STE 3E
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3010
Mailing Address - Country:US
Mailing Address - Phone:408-225-6815
Mailing Address - Fax:408-578-8309
Practice Address - Street 1:5710 CAHALAN AVE STE 3E
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-3010
Practice Address - Country:US
Practice Address - Phone:408-225-6815
Practice Address - Fax:408-578-8309
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHETTY&BHATIA DENTAL GROUP,INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty