Provider Demographics
NPI:1285243568
Name:CHANDI, GURPREET KAUR (DDS)
Entity type:Individual
Prefix:DR
First Name:GURPREET
Middle Name:KAUR
Last Name:CHANDI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 S 1ST ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-4531
Mailing Address - Country:US
Mailing Address - Phone:917-838-3359
Mailing Address - Fax:
Practice Address - Street 1:193 RIVER RD STE 230
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:CT
Practice Address - Zip Code:06351-3258
Practice Address - Country:US
Practice Address - Phone:315-706-4661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CT12857122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program