Healthcare Provider Details

I. General information

NPI: 1316184716
Provider Name (Legal Business Name): TANOJ C BHAKTA DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3058 E ATHENA AVE
GILBERT AZ
85297-8134
US

IV. Provider business mailing address

3058 E ATHENA AVE
GILBERT AZ
85297-8134
US

V. Phone/Fax

Practice location:
  • Phone: 480-247-2367
  • Fax: 480-847-3470
Mailing address:
  • Phone: 480-247-2367
  • Fax: 480-847-3470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number7559
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: