Provider Demographics
NPI:1093876336
Name:VISHVESHWAR S BATHEJA HUNTINGTON DENTAL CENTER
Entity Type:Organization
Organization Name:VISHVESHWAR S BATHEJA HUNTINGTON DENTAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VISHVESHWAR
Authorized Official - Middle Name:S
Authorized Official - Last Name:BATHEJA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-673-1862
Mailing Address - Street 1:1 SCHWAB ROAD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747
Mailing Address - Country:US
Mailing Address - Phone:631-673-1862
Mailing Address - Fax:631-673-1862
Practice Address - Street 1:1 SCHWAB ROAD
Practice Address - Street 2:SUITE 10
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747
Practice Address - Country:US
Practice Address - Phone:631-673-1862
Practice Address - Fax:631-673-1862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0354591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY035459OtherLICENSE