Provider Demographics
NPI:1023028453
Name:BHATT, NINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:BHATT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:26302 LA PAZ RD
Mailing Address - Street 2:SUITE 212
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5313
Mailing Address - Country:US
Mailing Address - Phone:949-470-9676
Mailing Address - Fax:949-470-9677
Practice Address - Street 1:26302 LA PAZ RD
Practice Address - Street 2:SUITE 212
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5313
Practice Address - Country:US
Practice Address - Phone:949-470-9676
Practice Address - Fax:949-470-9677
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA374781223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics