Provider Demographics
NPI:1770681124
Name:BHAKTA, AASHISH P (DMD)
Entity Type:Individual
Prefix:DR
First Name:AASHISH
Middle Name:P
Last Name:BHAKTA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 E DEBBIE LN
Mailing Address - Street 2:SUITE NUMBER 111
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-3356
Mailing Address - Country:US
Mailing Address - Phone:817-453-2983
Mailing Address - Fax:817-473-7341
Practice Address - Street 1:1205 E DEBBIE LN
Practice Address - Street 2:SUITE NUMBER 111
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-3356
Practice Address - Country:US
Practice Address - Phone:817-453-2983
Practice Address - Fax:817-473-7341
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX219891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice