Provider Demographics
NPI:1871770495
Name:REKHA CHANDURPAL GEHANI DENTIST P.C.
Entity type:Organization
Organization Name:REKHA CHANDURPAL GEHANI DENTIST P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REKHA
Authorized Official - Middle Name:CHANDURPAL
Authorized Official - Last Name:GEHANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-639-0192
Mailing Address - Street 1:3540 82ND ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5159
Mailing Address - Country:US
Mailing Address - Phone:718-639-0192
Mailing Address - Fax:718-639-8122
Practice Address - Street 1:3540 82ND ST
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5159
Practice Address - Country:US
Practice Address - Phone:718-639-0192
Practice Address - Fax:718-639-8122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0345491223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02526387Medicaid