Provider Demographics
NPI:1386961324
Name:JAGJIT BHUI
Entity type:Organization
Organization Name:JAGJIT BHUI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAGJIT
Authorized Official - Middle Name:S
Authorized Official - Last Name:BHUI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:1360-220-9117
Mailing Address - Street 1:9300 NE VANCOUVER MALL DR
Mailing Address - Street 2:SUITE# 100
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-8201
Mailing Address - Country:US
Mailing Address - Phone:360-695-5555
Mailing Address - Fax:360-253-6437
Practice Address - Street 1:9300 NE VANCOUVER MALL DR
Practice Address - Street 2:SUITE# 100
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-8201
Practice Address - Country:US
Practice Address - Phone:360-695-5555
Practice Address - Fax:360-253-6437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty