Provider Demographics
NPI:1518399518
Name:S. M. BHATT, D.D.S. INC.
Entity Type:Organization
Organization Name:S. M. BHATT, D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAILESHKUMAR
Authorized Official - Middle Name:M
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-961-1574
Mailing Address - Street 1:2545 S HACIENDA BLVD
Mailing Address - Street 2:
Mailing Address - City:HACIENDA HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91745-4706
Mailing Address - Country:US
Mailing Address - Phone:626-961-1574
Mailing Address - Fax:626-369-7455
Practice Address - Street 1:2545 S HACIENDA BLVD
Practice Address - Street 2:
Practice Address - City:HACIENDA HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91745-4706
Practice Address - Country:US
Practice Address - Phone:626-961-1574
Practice Address - Fax:626-369-7455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-01
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA335501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty