Provider Demographics
NPI:1225198476
Name:BHALODIA, SOHAL (DDS)
Entity Type:Individual
Prefix:DR
First Name:SOHAL
Middle Name:
Last Name:BHALODIA
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 1:7402 YORK RD STE 202
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-7520
Mailing Address - Country:US
Mailing Address - Phone:410-823-5900
Mailing Address - Fax:410-823-0721
Practice Address - Street 1:7402 YORK RD STE 202
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21204-7520
Practice Address - Country:US
Practice Address - Phone:410-823-5900
Practice Address - Fax:410-823-0721
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD136451223G0001X, 122300000X
PADS-0363171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101505905Medicaid