Provider Demographics
NPI:1861216103
Name:BHAKTA DENTAL P.C.
Entity type:Organization
Organization Name:BHAKTA DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAKTA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:562-869-3578
Mailing Address - Street 1:11540 DOWNEY AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4955
Mailing Address - Country:US
Mailing Address - Phone:562-869-3578
Mailing Address - Fax:562-381-7180
Practice Address - Street 1:11540 DOWNEY AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4955
Practice Address - Country:US
Practice Address - Phone:562-869-3578
Practice Address - Fax:562-381-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental