Provider Demographics
NPI:1104970615
Name:BHAGCHANDANI, SANJAY PARMANAND
Entity type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:PARMANAND
Last Name:BHAGCHANDANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5318 PATTERSON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-2044
Mailing Address - Country:US
Mailing Address - Phone:804-285-0400
Mailing Address - Fax:
Practice Address - Street 1:5318 PATTERSON AVE STE B
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-2044
Practice Address - Country:US
Practice Address - Phone:804-285-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist