Individual provider Active NPI

Nisha Bhorania, D.M.D, MPH

  • General Practice Dentistry
  • Georgetown, TX
National Provider Identifier
1356957880
Registry record updated Apr 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019032816 Issued in IL
Practice address
6779 W State Highway 29 Ste 200
Georgetown, TX 78628-6977
Phone
(737) 273-0828
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019032816 IL Primary

Addresses

Primary practice location

6779 W State Highway 29 Ste 200
Georgetown, TX 78628-6977

Mailing address

1109 N Interstate 35 Apt 1703
Austin, TX 78702-2063
Phone (630) 408-9174

Other practice location 1

1030 Norwood Park Blvd Ste 324
Austin, TX 78753-6609
Phone (512) 961-6200

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019032816ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Oak View Dental Group, LTD. General Practice PastSince Sep 1, 2020 Accepting new patients

Organizations & group practices 1

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": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713052800000",
    "number": "1356957880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 N INTERSTATE 35 APT 1703",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787022063",
            "telephone_number": "630-408-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6779 W STATE HIGHWAY 29 STE 200",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786286977",
            "telephone_number": "737-273-0828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1030 Norwood Park Blvd Ste 324",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787536609",
            "country_code": "US",
            "telephone_number": "512-961-6200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHORANIA",
        "first_name": "NISHA",
        "name_prefix": "Dr.",
        "credential": "D.M.D, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2024-04-14",
        "certification_date": "2024-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019032816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.