Healthcare Provider Details

I. General information

NPI: 1215643457
Provider Name (Legal Business Name): RAJVEE ROHITKUMAR BHAKTA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E CHAPMAN AVE
ORANGE CA
92866-2237
US

IV. Provider business mailing address

9091 MCBRIDE RIVER AVE
FOUNTAIN VALLEY CA
92708-6405
US

V. Phone/Fax

Practice location:
  • Phone: 714-583-6431
  • Fax:
Mailing address:
  • Phone: 714-486-6165
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS108494
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: