Provider Demographics
NPI:1952397093
Name:GULATI, ARVIND (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARVIND
Middle Name:
Last Name:GULATI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23655 NOVI RD STE 103
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-5442
Mailing Address - Country:US
Mailing Address - Phone:248-348-2115
Mailing Address - Fax:248-348-2595
Practice Address - Street 1:23655 NOVI RD STE 103
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-5442
Practice Address - Country:US
Practice Address - Phone:248-348-2115
Practice Address - Fax:248-348-2595
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI166961223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI11293026OtherCAQH NUMBER
MI16057OtherM-CARE
MI1326188OtherUNITED CONCORDIA
MI7931276OtherAETNA
MI97-5-63-0106-0OtherBC/BS OF MI
MI97-5-63-0106-0OtherBC/BS OF MI
MIN79840001Medicare PIN