Provider Demographics
NPI:1548780174
Name:BHUMIKA KATHIRIYA DDS, INC.
Entity Type:Organization
Organization Name:BHUMIKA KATHIRIYA DDS, INC.
Other - Org Name:RIVERSIDE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BHUMIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KATHIRIYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-784-5889
Mailing Address - Street 1:12926 RIVERSIDE DR STE D
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2292
Mailing Address - Country:US
Mailing Address - Phone:818-784-5889
Mailing Address - Fax:818-784-6832
Practice Address - Street 1:12926 RIVERSIDE DR STE D
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2292
Practice Address - Country:US
Practice Address - Phone:818-784-5889
Practice Address - Fax:818-784-6832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty