Provider Demographics
NPI:1245977941
Name:GANDHI, KAVERI KRANTI (MSD)
Entity type:Individual
Prefix:
First Name:KAVERI
Middle Name:KRANTI
Last Name:GANDHI
Suffix:
Gender:F
Credentials:MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5717 DURHAM CASTLE CT APT 321
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-5625
Mailing Address - Country:US
Mailing Address - Phone:513-857-9123
Mailing Address - Fax:
Practice Address - Street 1:3415 S LAFOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3802
Practice Address - Country:US
Practice Address - Phone:765-450-7780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-16
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INLDR1902351223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics