Healthcare Provider Details

I. General information

NPI: 1710446513
Provider Name (Legal Business Name): APARNA BHAT DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 S MERIDIAN STE 120
PUYALLUP WA
98373-1585
US

IV. Provider business mailing address

2910 S MERIDIAN STE 120
PUYALLUP WA
98373-1585
US

V. Phone/Fax

Practice location:
  • Phone: 253-445-0022
  • Fax:
Mailing address:
  • Phone: 253-445-0022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number61043211
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: