Provider Demographics
NPI:1891294740
Name:ABHISHEK BHAUMIK, PLLC
Entity Type:Organization
Organization Name:ABHISHEK BHAUMIK, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ABHISHEK
Authorized Official - Middle Name:
Authorized Official - Last Name:BHAUMIK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:469-384-8130
Mailing Address - Street 1:252 STONEBROOK PKWY STE 690
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3008
Mailing Address - Country:US
Mailing Address - Phone:469-384-8130
Mailing Address - Fax:
Practice Address - Street 1:252 STONEBROOK PKWY STE 690
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3008
Practice Address - Country:US
Practice Address - Phone:469-384-8130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX296071223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1750321363OtherNPPES