Provider Demographics
NPI:1821302845
Name:BHAGAT, MILAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MILAN
Middle Name:
Last Name:BHAGAT
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 1:3277 S CRATER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-9285
Mailing Address - Country:US
Mailing Address - Phone:804-732-5776
Mailing Address - Fax:804-732-5872
Practice Address - Street 1:11601 IRON BRIDGE RD STE 204
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VA
Practice Address - Zip Code:23831-1468
Practice Address - Country:US
Practice Address - Phone:804-717-5100
Practice Address - Fax:804-717-5103
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014140591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice