Provider Demographics
NPI:1427407568
Name:BAROT, KHUSHBU
Entity Type:Individual
Prefix:DR
First Name:KHUSHBU
Middle Name:
Last Name:BAROT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 SOMERSET LN APT 7
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-7756
Mailing Address - Country:US
Mailing Address - Phone:815-575-0861
Mailing Address - Fax:
Practice Address - Street 1:1768 W ALGONQUIN RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-3405
Practice Address - Country:US
Practice Address - Phone:331-234-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2018-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019030684122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist