Healthcare Provider Details

I. General information

NPI: 1326927294
Provider Name (Legal Business Name): GUNJAN AGRAWAL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 PROGRESS RD
HANNIBAL MO
63401-6637
US

IV. Provider business mailing address

900 E LAHARPE ST
KIRKSVILLE MO
63501-4520
US

V. Phone/Fax

Practice location:
  • Phone: 573-603-1460
  • Fax:
Mailing address:
  • Phone: 660-665-1962
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2026034857
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number41808
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: