Provider Demographics
NPI:1538503248
Name:GENTLE FAMILY DENTISTRY
Entity Type:Organization
Organization Name:GENTLE FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RIYAZ
Authorized Official - Middle Name:K
Authorized Official - Last Name:GANGJI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-861-0190
Mailing Address - Street 1:2431 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-5075
Mailing Address - Country:US
Mailing Address - Phone:610-861-0190
Mailing Address - Fax:610-861-3771
Practice Address - Street 1:2431 EASTON AVE
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-5075
Practice Address - Country:US
Practice Address - Phone:610-861-0190
Practice Address - Fax:610-861-3771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028456L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty