Provider Demographics
NPI:1760125322
Name:BHANAT, NAMRATA LALITCHANDRA (BDS)
Entity Type:Individual
Prefix:
First Name:NAMRATA LALITCHANDRA
Middle Name:
Last Name:BHANAT
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 1:132 WINDSOR HILLS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-9286
Mailing Address - Country:US
Mailing Address - Phone:270-320-1059
Mailing Address - Fax:
Practice Address - Street 1:20 MAPLE AVE STE 1
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-3582
Practice Address - Country:US
Practice Address - Phone:802-476-3171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016.0134080122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist