Provider Demographics
NPI:1972862878
Name:GANDHI, SHWETA A (DDS)
Entity Type:Individual
Prefix:
First Name:SHWETA
Middle Name:A
Last Name:GANDHI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SHWETA
Other - Middle Name:S
Other - Last Name:VORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:906 OAK TREE AVE STE M
Mailing Address - Street 2:
Mailing Address - City:SOUTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07080-5127
Mailing Address - Country:US
Mailing Address - Phone:908-222-3200
Mailing Address - Fax:
Practice Address - Street 1:906 OAK TREE AVE STE M
Practice Address - Street 2:
Practice Address - City:SOUTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07080-5127
Practice Address - Country:US
Practice Address - Phone:908-222-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY50 0568911223G0001X
NJ22DI026856001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice