Provider Demographics
NPI:1629363494
Name:DENTAL ASSOCIATES OF CHINO HILLS
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES OF CHINO HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYANT
Authorized Official - Middle Name:I
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-464-2811
Mailing Address - Street 1:2140 GRAND AVE STE 265
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-6806
Mailing Address - Country:US
Mailing Address - Phone:909-464-2811
Mailing Address - Fax:909-464-8484
Practice Address - Street 1:2140 GRAND AVE STE 265
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-6806
Practice Address - Country:US
Practice Address - Phone:909-464-2811
Practice Address - Fax:909-464-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty