Provider Demographics
NPI:1639800360
Name:GANDHI, AASTHA (DMD)
Entity Type:Individual
Prefix:
First Name:AASTHA
Middle Name:
Last Name:GANDHI
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 1:915 N FRANKLIN ST UNIT 1705
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-3799
Mailing Address - Country:US
Mailing Address - Phone:850-226-1041
Mailing Address - Fax:
Practice Address - Street 1:3550 HARDEN BLVD UNIT 101
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-5940
Practice Address - Country:US
Practice Address - Phone:863-226-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN27382122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist