Provider Demographics
NPI:1831546654
Name:BHARADWAJ, ANUSUYA KRISHNAN (DMD)
Entity type:Individual
Prefix:DR
First Name:ANUSUYA
Middle Name:KRISHNAN
Last Name:BHARADWAJ
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 1:675 CONTRA COSTA BLVD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1514
Mailing Address - Country:US
Mailing Address - Phone:925-231-4724
Mailing Address - Fax:
Practice Address - Street 1:4555 HOPYARD RD # C19
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-2771
Practice Address - Country:US
Practice Address - Phone:925-251-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1025311223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry