Healthcare Provider Details

I. General information

NPI: 1609735497
Provider Name (Legal Business Name): DIMPLE GANDHI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

766 NJ-35 STE 22
MIDDLETOWN NJ
07748
US

IV. Provider business mailing address

2 2ND ST APT 2804
JERSEY CITY NJ
07302-7023
US

V. Phone/Fax

Practice location:
  • Phone: 848-351-8058
  • Fax:
Mailing address:
  • Phone: 732-762-5272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI03113300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: