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General NPI Number Information
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NPI Number | 1225608342
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Entity Type | Individual
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Provider Name | ASHISH BHANDARI DMD
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Gender | Male
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 11082 SE OAK ST
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City | MILWAUKIE
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State | OR
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Zip | 97222-6692
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Country | US
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Telephone | 503-654-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 12241 SW 18TH AVE
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City | PORTLAND
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State | OR
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Zip | 97219-7779
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Country | US
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Telephone | 314-513-2673
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | D11954
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License Number State | OR
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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 | 019033178
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License Number State | IL
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