Provider Demographics
NPI:1629416771
Name:GEJJI, DIPTI (DDS)
Entity Type:Individual
Prefix:
First Name:DIPTI
Middle Name:
Last Name:GEJJI
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 1:3128 COWAN BLVD
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4975
Mailing Address - Country:US
Mailing Address - Phone:540-899-9511
Mailing Address - Fax:540-786-1994
Practice Address - Street 1:3128 COWAN BLVD
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4975
Practice Address - Country:US
Practice Address - Phone:540-899-9511
Practice Address - Fax:540-786-1994
Is Sole Proprietor?:No
Enumeration Date:2013-06-11
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414050122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist