Provider Demographics
NPI:1730425752
Name:KOTWANI, DIMPLE (DDS)
Entity type:Individual
Prefix:DR
First Name:DIMPLE
Middle Name:
Last Name:KOTWANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:DIMPLE
Other - Middle Name:
Other - Last Name:BACHANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:189 COAL BND
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-6531
Mailing Address - Country:US
Mailing Address - Phone:614-316-2124
Mailing Address - Fax:
Practice Address - Street 1:79 THURMAN AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-2685
Practice Address - Country:US
Practice Address - Phone:614-443-4625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-19
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-023799122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist