MEDICARE: DR. ROOPA P GANDHI BDS, MSD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	021002343	IL
2	1223P0221X	Pediatric Dentistry	DEN.00205362	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922113794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROOPA P GANDHI BDS, MSD

Provider Business Mailing Address
First Line	:	6935 S ROBERTSDALE WAY
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80016-7503
Country	:	US
Telephone Number	:	847-909-9765
Fax Number	:

Provider Business Practice Location Address
First Line	:	23750 E 14TH AVE STE 380
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80018-1978
Country	:	US
Telephone Number	:	720-277-9485
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	09/20/2024

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