Provider Demographics
NPI:1932692340
Name:GANDHI, ZIL (DMD)
Entity Type:Individual
Prefix:
First Name:ZIL
Middle Name:
Last Name:GANDHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ZIL
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1674 KELLER PKWY STE 180
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3756
Mailing Address - Country:US
Mailing Address - Phone:817-677-9090
Mailing Address - Fax:770-573-9513
Practice Address - Street 1:1674 KELLER PKWY STE 180
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3756
Practice Address - Country:US
Practice Address - Phone:817-677-9090
Practice Address - Fax:770-573-9513
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty