Provider Demographics
NPI:1043624158
Name:MAHINDRA, CHANDNI (DDS)
Entity type:Individual
Prefix:DR
First Name:CHANDNI
Middle Name:
Last Name:MAHINDRA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-2917
Mailing Address - Country:US
Mailing Address - Phone:732-766-4865
Mailing Address - Fax:
Practice Address - Street 1:19 SUMMER ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2917
Practice Address - Country:US
Practice Address - Phone:732-766-4865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice