=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699152868
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DRS. GANGLANI, JOHAL, DUNNING, AND ASSOCIATES I, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/27/2015
-----------------------------------------------------
Last Update Date | 12/30/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8528 PIT STOP CT NW STE 30
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28027-8221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-549-9922
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8528 PIT STOP CT NW STE 30
-----------------------------------------------------
City | CONCORD
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28027-8221
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-549-9922
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR-OWNER
-----------------------------------------------------
Name | DR. JOTINDER JOHAL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 704-549-9922
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 8457
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------