Provider Demographics
NPI:1659843142
Name:KHUSHBOO GANDHI DDS PLLC
Entity type:Organization
Organization Name:KHUSHBOO GANDHI DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KHUSHBOO
Authorized Official - Middle Name:
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-532-6506
Mailing Address - Street 1:350 W FM 544 STE 130
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4640
Mailing Address - Country:US
Mailing Address - Phone:972-532-6506
Mailing Address - Fax:
Practice Address - Street 1:350 W FM 544 STE 130
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4640
Practice Address - Country:US
Practice Address - Phone:972-532-6506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1366889164OtherNPPES