Provider Demographics
NPI:1609157825
Name:GAGLANI, ANUSHKA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANUSHKA
Middle Name:
Last Name:GAGLANI
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 1:777 N MICHIGAN AVE
Mailing Address - Street 2:APT. 903
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2617
Mailing Address - Country:US
Mailing Address - Phone:321-432-2685
Mailing Address - Fax:
Practice Address - Street 1:430 W ERIE ST
Practice Address - Street 2:STE. 200
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-6914
Practice Address - Country:US
Practice Address - Phone:920-838-1649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190286911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice