Provider Demographics
NPI:1932330271
Name:GANDHI, ADARSH (DDS)
Entity Type:Individual
Prefix:DR
First Name:ADARSH
Middle Name:
Last Name:GANDHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 W UNIVERSITY DR UNIT 3013
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85281-5082
Mailing Address - Country:US
Mailing Address - Phone:909-229-8592
Mailing Address - Fax:
Practice Address - Street 1:3414 W UNION HILLS DR STE 14
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4899
Practice Address - Country:US
Practice Address - Phone:623-688-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58548122300000X
AZD008962122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist