Provider Demographics
NPI:1174357529
Name:BHATTI, ASHMEET KAUR
Entity type:Individual
Prefix:
First Name:ASHMEET KAUR
Middle Name:
Last Name:BHATTI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16962 REDBUD LN
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-1019
Mailing Address - Country:US
Mailing Address - Phone:437-997-5354
Mailing Address - Fax:
Practice Address - Street 1:2034 N STATE ROUTE 50
Practice Address - Street 2:
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914-4410
Practice Address - Country:US
Practice Address - Phone:815-929-0222
Practice Address - Fax:815-929-0333
Is Sole Proprietor?:No
Enumeration Date:2024-08-28
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190355331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice