MEDICARE: HIMALI PATEL BHATT 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
1	122300000X	Dentist	DN1856475	MA
2	122300000X	Dentist	6685	NV
3	122300000X	Dentist	7104	NE

General Provider Information

NPI Number	:	1649610916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIMALI PATEL BHATT D.D.S

Provider Business Mailing Address
First Line	:	9516 W FLAMINGO RD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-5750
Country	:	US
Telephone Number	:	702-254-3135
Fax Number	:

Provider Business Practice Location Address
First Line	:	9516 W FLAMINGO RD STE 200
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89147-5750
Country	:	US
Telephone Number	:	702-254-3135
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2013
Last Update Date	:	08/31/2015

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