Provider Demographics
NPI:1134320005
Name:BHAKTA, RUPAL DINESHBHAI (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUPAL
Middle Name:DINESHBHAI
Last Name:BHAKTA
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 1:2409 BENT TRL
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-7573
Mailing Address - Country:US
Mailing Address - Phone:817-453-1804
Mailing Address - Fax:
Practice Address - Street 1:2409 BENT TRL
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-7573
Practice Address - Country:US
Practice Address - Phone:817-453-1804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22233122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist