Provider Demographics
NPI:1215939632
Name:GANDHI, URESH (BDS)
Entity type:Individual
Prefix:DR
First Name:URESH
Middle Name:
Last Name:GANDHI
Suffix:
Gender:M
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 BENITO ST
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3801
Mailing Address - Country:US
Mailing Address - Phone:516-565-9086
Mailing Address - Fax:
Practice Address - Street 1:200 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-2501
Practice Address - Country:US
Practice Address - Phone:631-842-0300
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033436122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist