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General NPI Number Information
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NPI Number | 1386890390
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Entity Type | Individual
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Provider Name | AVANI GANDHI DDS
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Gender | Female
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Dates
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Enumeration Date | 08/09/2008
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Last Update Date | 07/11/2013
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Provider Practice Location Address
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Address Line | 17202 DE GROOT PL
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City | CERRITOS
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State | CA
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Zip | 90703-1121
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Country | US
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Telephone | 415-810-6545
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Fax |
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Provider Business Mailing Address
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Address Line | 17202 DE GROOT PL
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City | CERRITOS
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State | CA
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Zip | 90703-1121
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Country | US
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Telephone | 415-810-6545
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 50 054005
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 56935
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 25252
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License Number State | TX
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