Provider Demographics
NPI:1194132332
Name:BHANSALI, NAMRATA (DDS)
Entity type:Individual
Prefix:DR
First Name:NAMRATA
Middle Name:
Last Name:BHANSALI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 N YORK RD STE 120
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-2994
Mailing Address - Country:US
Mailing Address - Phone:630-455-1666
Mailing Address - Fax:
Practice Address - Street 1:930 N YORK RD STE 120
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2994
Practice Address - Country:US
Practice Address - Phone:630-455-1666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190298371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice