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General NPI Number Information
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NPI Number | 1982017380
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Entity Type | Individual
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Provider Name | ISHITA BHAVSAR BDS, DMD, MS
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Gender | Female
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 11/16/2020
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Provider Practice Location Address
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Address Line | 638 NEWTOWN YARDLEY RD
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City | NEWTOWN
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State | PA
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Zip | 18940-1758
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Country | US
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Telephone | 215-968-9601
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Fax |
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Provider Business Mailing Address
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Address Line | 800 ROSE ST # D434
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City | LEXINGTON
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State | KY
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Zip | 40536-0297
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Country | US
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Telephone | 859-494-8029
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | DS042912
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License Number State | PA
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