Provider Demographics
NPI:1760962161
Name:AGGARWAL, KHUSHBOO NITIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:KHUSHBOO
Middle Name:NITIN
Last Name:AGGARWAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:KHUSHBOO
Other - Middle Name:HARSHAD
Other - Last Name:BRAHMBHATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BDS
Mailing Address - Street 1:2342B BRANDON ST SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3801
Mailing Address - Country:US
Mailing Address - Phone:205-354-4344
Mailing Address - Fax:
Practice Address - Street 1:2342B BRANDON ST SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3801
Practice Address - Country:US
Practice Address - Phone:205-354-4344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-16
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD6546C1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist