Provider Demographics
NPI:1336752948
Name:BHAKTA, SAAVAN (DMD)
Entity type:Individual
Prefix:
First Name:SAAVAN
Middle Name:
Last Name:BHAKTA
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 1:17551 BRIARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4401
Mailing Address - Country:US
Mailing Address - Phone:714-717-1006
Mailing Address - Fax:
Practice Address - Street 1:14021 N 51ST AVE STE 116
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4840
Practice Address - Country:US
Practice Address - Phone:602-529-3348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0119801223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology