Provider Demographics
NPI:1831712892
Name:DHARIA, BHUMI PATEL (DMD)
Entity type:Individual
Prefix:
First Name:BHUMI
Middle Name:PATEL
Last Name:DHARIA
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 1:201 4TH ST S UNIT 819
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4582
Mailing Address - Country:US
Mailing Address - Phone:908-240-5285
Mailing Address - Fax:
Practice Address - Street 1:7300 4TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-5924
Practice Address - Country:US
Practice Address - Phone:727-521-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRPM2195122300000X
390200000X
FLDN255181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program