Provider Demographics
NPI:1649165465
Name:BHALODI, ANAND PURUSHOTTAM (DDS)
Entity type:Individual
Prefix:DR
First Name:ANAND
Middle Name:PURUSHOTTAM
Last Name:BHALODI
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 1:6826 THISTLE ST
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:92880-9110
Mailing Address - Country:US
Mailing Address - Phone:840-200-5183
Mailing Address - Fax:
Practice Address - Street 1:939 S 12TH AVE
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5705
Practice Address - Country:US
Practice Address - Phone:844-767-0540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111666122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist