Individual provider Active NPI

Dhelni Tushar Bhatt, DMD

  • Dentist
  • Inglewood, CA
National Provider Identifier
1053821413
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104361 Issued in CA
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

Updated by the provider on Dec 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180522000808 WI Order and Referring Only - DentistPractitioner - Dentist 3476818451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104361CAMDDentist
1001696WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Familia Dental River Glen LLC PastSince Jun 22, 2021 Accepting new patients
Familia Dental River Glen LLC General Practice PastSince Jul 4, 2021 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.

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

Verify at the official NPI Registry.