Provider Demographics
NPI:1275598906
Name:SHROFF, BHAVNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:BHAVNA
Middle Name:
Last Name:SHROFF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 N 12TH ST
Mailing Address - Street 2:VCU-ORTHODONTICS-LYONS BUILDING-SUITE #111
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-1610
Mailing Address - Country:US
Mailing Address - Phone:804-828-9326
Mailing Address - Fax:804-828-5789
Practice Address - Street 1:520 N 12TH ST
Practice Address - Street 2:VCU-ORTHODONTICS-LYONS BUILDING-SUITE #111
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1610
Practice Address - Country:US
Practice Address - Phone:804-828-9326
Practice Address - Fax:804-828-5789
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA04010083041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics