Provider Demographics
NPI:1407125610
Name:JAIN, BHUMIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:BHUMIKA
Middle Name:
Last Name:JAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 VIDA LARGA LOOP
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-8666
Mailing Address - Country:US
Mailing Address - Phone:408-666-0290
Mailing Address - Fax:
Practice Address - Street 1:1130 VIDA LARGA LOOP
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-8666
Practice Address - Country:US
Practice Address - Phone:408-666-0290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2011-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA609971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice