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General NPI Number Information
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NPI Number | 1417417429
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Entity Type | Individual
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Provider Name | RICHA SUNIL BANTHIA DDS
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Gender | Female
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 5770 N HAMILTON RD STE A
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City | COLUMBUS
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State | OH
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Zip | 43230-3584
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Country | US
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Telephone | 614-907-4401
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Fax |
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Provider Business Mailing Address
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Address Line | 15212 SUMMER PARK LN
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City | BATON ROUGE
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State | LA
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Zip | 70817-3083
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Country | US
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Telephone |
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 30.026545
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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