Provider Demographics
NPI:1124402581
Name:BHATNAGAR, ABHINAV (DMD)
Entity type:Individual
Prefix:
First Name:ABHINAV
Middle Name:
Last Name:BHATNAGAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 NW 174TH CIR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-9647
Mailing Address - Country:US
Mailing Address - Phone:404-667-4259
Mailing Address - Fax:
Practice Address - Street 1:2226 24TH AVE NW
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6496
Practice Address - Country:US
Practice Address - Phone:405-252-1457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6729122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist