MEDICARE: DR. BHAVIN CHATRABHUJ CHANGELA 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	1223G0001X	General Practice Dentistry	49487	CA

General Provider Information

NPI Number	:	1679630750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHAVIN CHATRABHUJ CHANGELA D.D.S.

Provider Business Mailing Address
First Line	:	3280 CHINO HILLS PKWY
Second Line	:	#4
City	:	CHINO HILLS
State	:	CA
Zip	:	91709-5865
Country	:	US
Telephone Number	:	909-606-9907
Fax Number	:	909-606-9945

Provider Business Practice Location Address
First Line	:	2407 VALLEY BLVD
Second Line	:	SUITE C-1
City	:	POMONA
State	:	CA
Zip	:	91768-2761
Country	:	US
Telephone Number	:	909-839-1004
Fax Number	:	909-839-1017

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

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	02/05/2015

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