Provider Demographics
NPI:1790531952
Name:ABHINAV BHATNAGAR PLLC
Entity type:Organization
Organization Name:ABHINAV BHATNAGAR PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABHINAV
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATNAGAR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:404-667-4259
Mailing Address - Street 1:2816 NW 58TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-6899
Mailing Address - Country:US
Mailing Address - Phone:405-390-7400
Mailing Address - Fax:
Practice Address - Street 1:2816 NW 58TH ST STE 105
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6899
Practice Address - Country:US
Practice Address - Phone:405-390-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty