Provider Demographics
NPI:1871960666
Name:BAKSHI, NAVKARAN
Entity type:Individual
Prefix:
First Name:NAVKARAN
Middle Name:
Last Name:BAKSHI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 HILLANDALE RD
Mailing Address - Street 2:APT # 89
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-2378
Mailing Address - Country:US
Mailing Address - Phone:423-366-6161
Mailing Address - Fax:
Practice Address - Street 1:6134 WHITE HORSE RD
Practice Address - Street 2:FAMILY DENTAL
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29611-3837
Practice Address - Country:US
Practice Address - Phone:423-366-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC86371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice