Provider Demographics
NPI:1740753789
Name:BHUSE, KRUTTIKA S (BDS)
Entity Type:Individual
Prefix:
First Name:KRUTTIKA
Middle Name:S
Last Name:BHUSE
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 BROWNWAY ST APT 1412
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-4937
Mailing Address - Country:US
Mailing Address - Phone:512-939-2540
Mailing Address - Fax:
Practice Address - Street 1:5250 BROWNWAY ST APT 1412
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-4937
Practice Address - Country:US
Practice Address - Phone:512-939-2540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT12423390200000X
TX392131223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program