Provider Demographics
NPI:1316353204
Name:BHATTI, YUSUF KHALID (DMD)
Entity type:Individual
Prefix:DR
First Name:YUSUF
Middle Name:KHALID
Last Name:BHATTI
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1130 RIVERFRONT CTR
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010-4600
Mailing Address - Country:US
Mailing Address - Phone:518-992-5437
Mailing Address - Fax:518-348-8888
Practice Address - Street 1:1130 RIVERFRONT CTR
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010-4600
Practice Address - Country:US
Practice Address - Phone:518-992-5437
Practice Address - Fax:518-348-8888
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLL7561223P0221X
NY0585361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04530503Medicaid
MD119591300Medicaid