Provider Demographics
NPI:1861608655
Name:MISTRY, BHAGWATI J (DDS, MDS)
Entity type:Individual
Prefix:DR
First Name:BHAGWATI
Middle Name:J
Last Name:MISTRY
Suffix:
Gender:F
Credentials:DDS, MDS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:11 BEECH LN
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-3001
Mailing Address - Country:US
Mailing Address - Phone:914-631-2134
Mailing Address - Fax:914-524-9021
Practice Address - Street 1:11 BEECH LN
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-3001
Practice Address - Country:US
Practice Address - Phone:914-631-2134
Practice Address - Fax:914-524-9021
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0345561223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry