Provider Demographics
NPI:1669822961
Name:GANDHI, YESHABEN D (DDS)
Entity Type:Individual
Prefix:DR
First Name:YESHABEN
Middle Name:D
Last Name:GANDHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:YESHABEN
Other - Middle Name:MUKESHCHANDRA
Other - Last Name:LAKDAWALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BDS
Mailing Address - Street 1:4857 SALLY CT
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-5136
Mailing Address - Country:US
Mailing Address - Phone:314-783-7259
Mailing Address - Fax:
Practice Address - Street 1:1704 MIRAMONTE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3766
Practice Address - Country:US
Practice Address - Phone:314-783-7259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-16
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA100276122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist