Provider Demographics
NPI:1154317667
Name:AMIN, BACHU (DDS)
Entity Type:Individual
Prefix:MR
First Name:BACHU
Middle Name:
Last Name:AMIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 NW TOPEKA BLVD
Mailing Address - Street 2:STE 111
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66608-1824
Mailing Address - Country:US
Mailing Address - Phone:785-285-6219
Mailing Address - Fax:785-232-9410
Practice Address - Street 1:1835 NW TOPEKA BLVD
Practice Address - Street 2:STE 111
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66608-1824
Practice Address - Country:US
Practice Address - Phone:785-285-6219
Practice Address - Fax:785-232-9410
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS62241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS008845OtherBCBS
627337OtherUNITED CONCORDIA