Provider Demographics
NPI:1629605019
Name:THAKKAR, BHAVIKA V (DDS)
Entity Type:Individual
Prefix:DR
First Name:BHAVIKA
Middle Name:V
Last Name:THAKKAR
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 1:8045 METCALF AVE APT 327
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-3871
Mailing Address - Country:US
Mailing Address - Phone:917-562-4098
Mailing Address - Fax:
Practice Address - Street 1:650 E 25TH ST RM 277
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2716
Practice Address - Country:US
Practice Address - Phone:816-235-2121
Practice Address - Fax:816-235-5526
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37190122300000X
MO20220178661223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist