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NPI Code Detail

MEDICARE: DR. DHARTI J BHAKTA D.D.S.

MEDICARE: DR. DHARTI J BHAKTA D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistD5508AZ

General Provider Information

NPI Number : 1184878977
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DHARTI J BHAKTA D.D.S.
Provider Business Mailing Address
First Line : 4008 N 33RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-4510
Country : US
Telephone Number : 602-266-9659
Fax Number : 602-266-8275
Provider Business Practice Location Address
First Line : 4008 N 33RD AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85017-4510
Country : US
Telephone Number : 602-266-9659
Fax Number : 602-266-8275
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2008
Last Update Date : 11/06/2008

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