Healthcare Provider Details

I. General information

NPI: 1043139421
Provider Name (Legal Business Name): S BHATIA DENTAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1305 N WILLOW AVE STE 110
CLOVIS CA
93619-4857
US

IV. Provider business mailing address

1305 N WILLOW AVE STE 110
CLOVIS CA
93619-4857
US

V. Phone/Fax

Practice location:
  • Phone: 559-612-1010
  • Fax:
Mailing address:
  • Phone: 559-612-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. MITIN BHATIA
Title or Position: CEO
Credential: DDS
Phone: 415-518-7862