Provider Demographics
NPI:1205997558
Name:BATHEJA, VISHVESHWAR S (DDS)
Entity type:Individual
Prefix:DR
First Name:VISHVESHWAR
Middle Name:S
Last Name:BATHEJA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HUNTINGTON DENTAL CENTER
Mailing Address - Street 2:1 SCHWAB ROAD, SUITE 10
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747
Mailing Address - Country:US
Mailing Address - Phone:631-673-1862
Mailing Address - Fax:631-673-1862
Practice Address - Street 1:HUNTINGTON DENTAL CENTER
Practice Address - Street 2:1 SCHWAB ROAD, SUITE 10
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747
Practice Address - Country:US
Practice Address - Phone:631-673-1862
Practice Address - Fax:631-673-1862
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0354591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY035459OtherNY LICENSE