# BHARGAVA DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366503211
- **Authorized official:** DR. NEIL BHARGAVA DDS (OWNER)
- **Authorized official phone:** (316) 630-0002

## Contact information

- **Practice address:** 1230 N BROADMOOR AVE, STE \# 300, WICHITA, KS 67206-3891
- **Practice address phone:** (316) 630-0002
- **Practice address fax:** (316) 630-0004
- **Mailing address:** 1230 N BROADMOOR AVE, STE \# 300, WICHITA, KS 67206-3891
- **Mailing address phone:** (316) 630-0002
- **Mailing address fax:** (316) 630-0004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 60181 | KS | — |
| 1223G0001X | General Practice Dentistry | 60182 | KS | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 08/22/2020