Healthcare Provider Details

I. General information

NPI: 1407396062
Provider Name (Legal Business Name): BHATIA DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6721 N MILBURN AVE STE 101
FRESNO CA
93722-2140
US

IV. Provider business mailing address

6721 N MILBURN AVE STE 101
FRESNO CA
93722-2140
US

V. Phone/Fax

Practice location:
  • Phone: 559-825-0990
  • Fax: 559-468-0122
Mailing address:
  • Phone: 559-825-0990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number58882
License Number StateCA

VIII. Authorized Official

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