Raj Brahmbhatt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4063 Issued in AR

Practice address

3533 N Shiloh Dr
Suite 3
Fayetteville, AR 72703-5359

Phone

(479) 445-6335

Fax

(479) 301-2878

NPI assigned

Jul 8, 2015

Last updated

Jul 8, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436313600000",
    "number": "1497138549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4375 N VANTAGE DR",
            "address_2": "SUITE 202",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034982",
            "telephone_number": "479-445-6335",
            "fax_number": "479-301-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 N SHILOH DR",
            "address_2": "SUITE 3",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727035359",
            "telephone_number": "479-445-6335",
            "fax_number": "479-301-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAHMBHATT",
        "first_name": "RAJ",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-08",
        "last_updated": "2015-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew S Bradley, MD
• Rebecca Bradley
• Stanley Bradley, MD
• Erin S Brady, DDS
• Jana Lynn Brady, L.AC., DOM
• Brainpower Neuropsychology, PLC
• Kevin Drake Branch, M.D.
• Brooke E Brander, DO
• Diane M Brandmiller, PH.D.
• Carla Dawn Brandow, MMT

• General Practice Dentistry in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• General Practice Dentistry in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2015; 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.