Provider Demographics
NPI:1356468987
Name:BHANDARI, RAMESH G (DMD)
Entity Type:Individual
Prefix:
First Name:RAMESH
Middle Name:G
Last Name:BHANDARI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:561 CHENANGO ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-2103
Mailing Address - Country:US
Mailing Address - Phone:607-723-0101
Mailing Address - Fax:607-723-1710
Practice Address - Street 1:561 CHENANGO ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-2103
Practice Address - Country:US
Practice Address - Phone:607-723-0101
Practice Address - Fax:607-723-1710
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0308071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00578083Medicaid