Provider Demographics
NPI:1407662281
Name:HAMMONDS, ARTI BHAKTA (CRDH)
Entity type:Individual
Prefix:
First Name:ARTI
Middle Name:BHAKTA
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:CRDH
Other - Prefix:
Other - First Name:ARTI
Other - Middle Name:HARISH
Other - Last Name:BHAKTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRDH
Mailing Address - Street 1:964 AJAX STREET
Mailing Address - Street 2:BUILDING 964
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32212
Mailing Address - Country:US
Mailing Address - Phone:904-546-7168
Mailing Address - Fax:
Practice Address - Street 1:2080 CHILD ST DEPT 5000
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-5000
Practice Address - Country:US
Practice Address - Phone:904-546-7168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH24551124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist