Provider Demographics
NPI:1730434325
Name:KATHIRIYA, BHUMIKA (DDS)
Entity type:Individual
Prefix:DR
First Name:BHUMIKA
Middle Name:
Last Name:KATHIRIYA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26012 OHARA LN
Mailing Address - Street 2:
Mailing Address - City:STEVENSON RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91381-1109
Mailing Address - Country:US
Mailing Address - Phone:323-397-7310
Mailing Address - Fax:
Practice Address - Street 1:12926 RIVERSIDE DR STE D
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2292
Practice Address - Country:US
Practice Address - Phone:818-784-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist