Provider Demographics
NPI:1386026946
Name:GANDHI, DHARTI (DDS)
Entity Type:Individual
Prefix:DR
First Name:DHARTI
Middle Name:
Last Name:GANDHI
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 1:1400 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-2229
Mailing Address - Country:US
Mailing Address - Phone:303-825-2295
Mailing Address - Fax:303-825-2244
Practice Address - Street 1:1400 GROVE ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-2229
Practice Address - Country:US
Practice Address - Phone:303-825-2295
Practice Address - Fax:303-825-2244
Is Sole Proprietor?:No
Enumeration Date:2015-06-19
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO202540122300000X
MO2015016763122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO95052771Medicaid