Healthcare Provider Details

I. General information

NPI: 1396888582
Provider Name (Legal Business Name): BHARATI J. BEDI, D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 12/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 GREENBELT PKWY
HOLTSVILLE NY
11742-2207
US

IV. Provider business mailing address

280 GREENBELT PKWY
HOLTSVILLE NY
11742-2207
US

V. Phone/Fax

Practice location:
  • Phone: 631-472-1832
  • Fax: 631-472-9725
Mailing address:
  • Phone: 631-472-1832
  • Fax: 631-472-9725

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number051346
License Number StateNY

VIII. Authorized Official

Name: DR. BHARATI JASMEET BEDI
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 631-472-1832