Provider Demographics
NPI:1073686952
Name:BHATTI, BHAWNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:BHAWNA
Middle Name:
Last Name:BHATTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 ERNSTON RD
Mailing Address - Street 2:
Mailing Address - City:PARLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08859-1937
Mailing Address - Country:US
Mailing Address - Phone:732-721-3311
Mailing Address - Fax:732-721-3543
Practice Address - Street 1:314 ERNSTON RD
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1937
Practice Address - Country:US
Practice Address - Phone:732-721-3311
Practice Address - Fax:732-721-3543
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022966001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0119261Medicaid