Healthcare Provider Details

I. General information

NPI: 1770384349
Provider Name (Legal Business Name): DR. NICK NIKHIL BHATT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 EUBANK BLVD NE STE 14
ALBUQUERQUE NM
87111-3427
US

IV. Provider business mailing address

12200 ACADEMY RD NE APT 1025
ALBUQUERQUE NM
87111-7253
US

V. Phone/Fax

Practice location:
  • Phone: 505-337-4229
  • Fax:
Mailing address:
  • Phone: 920-263-8435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDB-2026-0344
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: