Provider Demographics
NPI:1558934422
Name:BHAKTA, JAY PRAFUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:PRAFUL
Last Name:BHAKTA
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 1:1941 S OHIO CT
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-6602
Mailing Address - Country:US
Mailing Address - Phone:785-825-9125
Mailing Address - Fax:
Practice Address - Street 1:1941 S OHIO CT
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-6602
Practice Address - Country:US
Practice Address - Phone:785-825-9125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-20
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61822122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist