Provider Demographics
NPI:1073677993
Name:GULATI, BINDU
Entity type:Individual
Prefix:DR
First Name:BINDU
Middle Name:
Last Name:GULATI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 W OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-2299
Mailing Address - Country:US
Mailing Address - Phone:630-803-8883
Mailing Address - Fax:630-241-6894
Practice Address - Street 1:407 W OGDEN AVE STE 150
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-2299
Practice Address - Country:US
Practice Address - Phone:630-803-8883
Practice Address - Fax:630-241-6894
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019025118122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist