Healthcare Provider Details

I. General information

NPI: 1831432616
Provider Name (Legal Business Name): ASHWINI SHIRISH BHAVE B.D.S., M.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2013
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 W HAMILTON AVE STE 100
CAMPBELL CA
95008-0555
US

IV. Provider business mailing address

124 GARDEN HILL DR
LOS GATOS CA
95032-7665
US

V. Phone/Fax

Practice location:
  • Phone: 408-370-1185
  • Fax: 408-370-7716
Mailing address:
  • Phone: 909-557-3009
  • Fax: 408-370-7716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE60351086
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number2901021409
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberA-14265
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License NumberDDS100730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: