Provider Demographics
NPI:1437823259
Name:GAJJAR, BHAVIN H (DDS)
Entity Type:Individual
Prefix:
First Name:BHAVIN
Middle Name:H
Last Name:GAJJAR
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 1:908 NW 57TH STREET
Mailing Address - Street 2:
Mailing Address - City:GAINSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:908 NW 57TH STREET
Practice Address - Street 2:
Practice Address - City:GAINSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605
Practice Address - Country:US
Practice Address - Phone:352-332-8199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX376231223G0001X
ORD115461223G0001X
FLDN288021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice