Provider Demographics
NPI:1720405442
Name:NAMRATA K. BHULLAR DDS INC.
Entity Type:Organization
Organization Name:NAMRATA K. BHULLAR DDS INC.
Other - Org Name:HERCULES KIDS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NAMRATA
Authorized Official - Middle Name:KAUR
Authorized Official - Last Name:BHULLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-307-8289
Mailing Address - Street 1:500 ALFRED NOBEL DR STE 180
Mailing Address - Street 2:
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-1842
Mailing Address - Country:US
Mailing Address - Phone:559-307-8289
Mailing Address - Fax:
Practice Address - Street 1:500 ALFRED NOBEL DR STE 180
Practice Address - Street 2:
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547-1842
Practice Address - Country:US
Practice Address - Phone:559-307-8289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA537561223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty