Provider Demographics
NPI:1053076703
Name:BHATIA, SMRITI (BDS)
Entity Type:Individual
Prefix:DR
First Name:SMRITI
Middle Name:
Last Name:BHATIA
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:SMRITI
Other - Middle Name:
Other - Last Name:RAJAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 LILLY RD NE STE A
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-6101
Mailing Address - Country:US
Mailing Address - Phone:360-459-4800
Mailing Address - Fax:
Practice Address - Street 1:220 LILLY RD NE STE A
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-6101
Practice Address - Country:US
Practice Address - Phone:360-459-4800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-07
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE612310431223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics