Provider Demographics
NPI:1396888582
Name:BHARATI J. BEDI, D.D.S., P.C.
Entity type:Organization
Organization Name:BHARATI J. BEDI, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BHARATI
Authorized Official - Middle Name:JASMEET
Authorized Official - Last Name:BEDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-472-1832
Mailing Address - Street 1:280 GREENBELT PKWY
Mailing Address - Street 2:
Mailing Address - City:HOLTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11742-2207
Mailing Address - Country:US
Mailing Address - Phone:631-472-1832
Mailing Address - Fax:631-472-9725
Practice Address - Street 1:280 GREENBELT PKWY
Practice Address - Street 2:
Practice Address - City:HOLTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11742-2207
Practice Address - Country:US
Practice Address - Phone:631-472-1832
Practice Address - Fax:631-472-9725
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2007-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0513461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9178281OtherDORAL
NY02633416Medicaid