Provider Demographics
NPI:1639519382
Name:BHASIN, RANJU (DDS)
Entity Type:Individual
Prefix:DR
First Name:RANJU
Middle Name:
Last Name:BHASIN
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 1:3020 SENECA CHIEF TRL
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-1418
Mailing Address - Country:US
Mailing Address - Phone:443-538-4649
Mailing Address - Fax:
Practice Address - Street 1:3020 SENECA CHIEF TRL
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-1418
Practice Address - Country:US
Practice Address - Phone:443-538-4649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL11905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist