Provider Demographics
NPI:1487652863
Name:BHATIA, MONIKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MONIKA
Middle Name:
Last Name:BHATIA
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 1:267 W OLD COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-4014
Mailing Address - Country:US
Mailing Address - Phone:516-935-5391
Mailing Address - Fax:516-935-5392
Practice Address - Street 1:267 W OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-4014
Practice Address - Country:US
Practice Address - Phone:516-935-5391
Practice Address - Fax:516-935-5392
Is Sole Proprietor?:No
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0509451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02526878Medicaid