Healthcare Provider Details

I. General information

NPI: 1205059052
Provider Name (Legal Business Name): RAMESH CHANDER BHATHEJA B.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 S HIAWASSEE RD STE 135
ORLANDO FL
32835
US

IV. Provider business mailing address

1603 S HIAWASSEE RD STE 135
ORLANDO FL
32835-6439
US

V. Phone/Fax

Practice location:
  • Phone: 407-293-8324
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN0009548
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: