Provider Demographics
NPI:1194183400
Name:VISHAL GANDHI DDS LLC
Entity Type:Organization
Organization Name:VISHAL GANDHI DDS LLC
Other - Org Name:WESTGATE SMILES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:VISHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-855-9337
Mailing Address - Street 1:836 W BARTLETT RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4402
Mailing Address - Country:US
Mailing Address - Phone:630-855-9337
Mailing Address - Fax:630-622-4951
Practice Address - Street 1:836 W BARTLETT RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4402
Practice Address - Country:US
Practice Address - Phone:630-855-9337
Practice Address - Fax:630-622-4951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028530122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty