Jayganesh Manoj Bhatt, D.D.S
Individual provider Active NPI Dentist · Gilbert, AZ
NPI 1881887362 · NPPES record last updated Aug 20, 2007
Key facts
- NPI
- 1881887362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- BB9405689 (AZ)
- Practice address
- 3341 E Queen Creek Rd Ste 101
Gilbert, AZ 85297-8501 - Phone
- (480) 305-3200
- NPI assigned
- Aug 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BB9405689 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Serenity Dental | Dentist | Past | Accepting new patients |
| Serenity Dental Offices LLC | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | BB9405689 | AZ | Yes |
Addresses
Primary practice location
3341 E Queen Creek Rd Ste 101
Gilbert, AZ 85297-8501
Mailing address
3341 E Queen Creek Rd Ste 101
Gilbert, AZ 85297-8501
Phone (480) 305-3200
Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.