Provider Demographics
NPI:1205124245
Name:BHAT, PRAVEENA PRASHANT (DMD)
Entity type:Individual
Prefix:DR
First Name:PRAVEENA
Middle Name:PRASHANT
Last Name:BHAT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 NEWFANE RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4844
Mailing Address - Country:US
Mailing Address - Phone:603-488-5915
Mailing Address - Fax:
Practice Address - Street 1:537 AMHERST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1013
Practice Address - Country:US
Practice Address - Phone:603-882-3885
Practice Address - Fax:603-595-2833
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03841122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist