Active NPI
Dhelni Tushar Bhatt, DMD
- Dentist
- Inglewood, CA
National Provider Identifier
1053821413
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 104361
- Practice address
- 3561 W Century Blvd
Inglewood, CA 90303-1223 - Phone
- (323) 483-7042
- NPI assigned
- Oct 11, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1001696 | WI | |
| Dentist | 122300000X | 104361 | CA | Primary |
Addresses
Primary practice location
3561 W Century Blvd
Inglewood, CA 90303-1223
Mailing address
3561 W Century Blvd
Inglewood, CA 90303-1223
Phone (323) 483-7042
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20180522000808 | WI | Order and Referring Only - Dentist | 3476818451 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104361 | CA | MD | Dentist |
| 1001696 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familia Dental River Glen LLC | Past | Accepting new patients | |
| Familia Dental River Glen LLC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Milwaukee, WI
- NPI 1285202978
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606867200000",
"number": "1053821413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3561 W CENTURY BLVD",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "903031223",
"telephone_number": "323-483-7042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3561 W CENTURY BLVD",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "903031223",
"telephone_number": "323-483-7042"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BHATT",
"first_name": "DHELNI",
"middle_name": "TUSHAR",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-11",
"last_updated": "2020-12-02",
"certification_date": "2020-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "1001696",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "104361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Inglewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.