Healthcare Provider Details

I. General information

NPI: 1710010822
Provider Name (Legal Business Name): SATISH M BHAMBHANI BDS, DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

636 N FRENCH RD STE 5 WEST AMHERST OFFICE PARK
AMHERST NY
14228-1900
US

IV. Provider business mailing address

636 N FRENCH RD STE 5 WEST AMHERST OFFICE PARK
AMHERST NY
14228-1900
US

V. Phone/Fax

Practice location:
  • Phone: 716-691-2481
  • Fax: 716-691-2487
Mailing address:
  • Phone: 716-691-2481
  • Fax: 716-691-2487

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number048868
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: