Healthcare Provider Details

I. General information

NPI: 1851090708
Provider Name (Legal Business Name): BHATIA & BHATIA DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2023
Last Update Date: 03/01/2023
Certification Date: 03/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2141 SHAW AVE STE 105
CLOVIS CA
93611-8916
US

IV. Provider business mailing address

PO BOX 25640
FRESNO CA
93729-5640
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SHELJA BHATIA
Title or Position: CEO
Credential: DDS
Phone: 415-866-8852