Provider Demographics
NPI:1023421419
Name:GAJERA, GARGI KISHOR (DMD)
Entity type:Individual
Prefix:DR
First Name:GARGI
Middle Name:KISHOR
Last Name:GAJERA
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 1:33 WINDEMERE WAY
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1529
Mailing Address - Country:US
Mailing Address - Phone:931-801-1804
Mailing Address - Fax:
Practice Address - Street 1:257-10 UNION TURNPIKE
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-0000
Practice Address - Country:US
Practice Address - Phone:516-987-6464
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058023122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist