Provider Demographics
NPI:1528253606
Name:BHUT, CHANDRIKA N (DDS)
Entity type:Individual
Prefix:
First Name:CHANDRIKA
Middle Name:N
Last Name:BHUT
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 1:19785 CRYSTAL ROCK DR STE 302
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-4732
Mailing Address - Country:US
Mailing Address - Phone:301-515-5955
Mailing Address - Fax:301-515-5957
Practice Address - Street 1:19785 CRYSTAL ROCK DR STE 302
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-4732
Practice Address - Country:US
Practice Address - Phone:301-515-5955
Practice Address - Fax:301-515-5957
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice