Provider Demographics
NPI:1417407248
Name:GULATI, JASWINDER (DMD)
Entity Type:Individual
Prefix:
First Name:JASWINDER
Middle Name:
Last Name:GULATI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BRIGHT DENTAL
Mailing Address - Street 2:1200 PARK STREET, SUITE C
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:860-951-3800
Mailing Address - Fax:860-951-3803
Practice Address - Street 1:939 WOLCOTT STREET UNIT 5B
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705
Practice Address - Country:US
Practice Address - Phone:203-575-9944
Practice Address - Fax:203-575-9946
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.030971122300000X
IL019030971122300000X
CT11909122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist