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General NPI Number Information
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NPI Number | 1063016814
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Entity Type | Individual
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Provider Name | ATANAS BOGATINOV DMD
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Gender | Male
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | ELITE DENTAL OF HIGHLAND, 2327 45TH STREET
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City | HIGHLAND
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State | IN
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Zip | 46322
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Country | US
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Telephone | 219-924-1193
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Fax |
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Provider Business Mailing Address
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Address Line | 1001 S STATE ST
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City | CHICAGO
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State | IL
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Zip | 60605-2226
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Country | US
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Telephone | 631-965-3631
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12014866A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN1860029
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License Number State | MA
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