Provider Demographics
NPI:1003025578
Name:S.M. BHATT, DDS, INC
Entity Type:Organization
Organization Name:S.M. BHATT, DDS, INC
Other - Org Name:VICTORVILLE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAILESHKUMAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-245-7800
Mailing Address - Street 1:14495 7TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-4233
Mailing Address - Country:US
Mailing Address - Phone:760-245-7800
Mailing Address - Fax:760-245-6326
Practice Address - Street 1:14495 7TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-4233
Practice Address - Country:US
Practice Address - Phone:760-245-7800
Practice Address - Fax:760-245-6326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33550122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty