Provider Demographics
NPI:1649610288
Name:GANDHI, PRANAV VIJAY (DDS)
Entity type:Individual
Prefix:DR
First Name:PRANAV
Middle Name:VIJAY
Last Name:GANDHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 HOLLY AVE
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4942
Mailing Address - Country:US
Mailing Address - Phone:917-297-4251
Mailing Address - Fax:
Practice Address - Street 1:4600 ROSWELL RD
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30342-3075
Practice Address - Country:US
Practice Address - Phone:917-297-4251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN123409122300000X
TX29177122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist