Provider Demographics
NPI:1245770411
Name:JENNY GANDHI
Entity Type:Organization
Organization Name:JENNY GANDHI
Other - Org Name:PEARL. DENTISTRY REIMAGINED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-941-3740
Mailing Address - Street 1:150 N COLLEGE ST
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-2271
Mailing Address - Country:US
Mailing Address - Phone:704-941-3740
Mailing Address - Fax:704-941-3744
Practice Address - Street 1:150 N COLLEGE ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28202-2271
Practice Address - Country:US
Practice Address - Phone:704-941-3740
Practice Address - Fax:704-941-3744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC095861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty