Provider Demographics
NPI:1154219996
Name:RAGHAV, BHAWANA
Entity type:Individual
Prefix:
First Name:BHAWANA
Middle Name:
Last Name:RAGHAV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 PINE CREST CT
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-8088
Mailing Address - Country:US
Mailing Address - Phone:217-220-7974
Mailing Address - Fax:
Practice Address - Street 1:222 W CUNNINGHAM ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5790
Practice Address - Country:US
Practice Address - Phone:724-298-2108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0452411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice