Sandeep Bhagat, DMD

Individual provider Active NPI General Practice Dentistry · Corona, NY

NPI 1043433121 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1043433121
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
048767 (NY)
Practice address
38-09 Junction Boulevard
2ND Floor
Corona, NY 11368
Phone
(718) 639-7100
NPI assigned
Apr 10, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
048767NYMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 048767 NY Yes

Addresses

Primary practice location

38-09 Junction Boulevard
2ND Floor
Corona, NY 11368

Mailing address

1292 Port Washington Boulevard.
Port Washington, NY 11050
Phone (516) 365-5043

Other identifiers

IdentifierTypeStateIssuer
02074784MedicaidNY

Other providers in Corona, NY

All providers in Corona, NY · General Practice Dentistry in New York

Sources for this page

Verify at the official NPI Registry.