Radha Varun Gandhi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

108959 Issued in CA

Practice address

1276 Halyard Dr
W Sacramento, CA 95691-3412

Phone

(916) 454-2345

NPI assigned

May 31, 2022

Last updated

Aug 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Radha Gaurangkumar Patel Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1417696279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BADGER CREEK CT",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629535",
            "telephone_number": "408-930-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 HALYARD DR",
            "city": "W SACRAMENTO",
            "state": "CA",
            "postal_code": "956913412",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "77 Cadillac Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958258337",
            "country_code": "US",
            "telephone_number": "916-454-2345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5385 Franklin Blvd Ste K",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958204717",
            "country_code": "US",
            "telephone_number": "916-454-2345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4815 Watt Ave",
            "address_purpose": "LOCATION",
            "city": "North Highlands",
            "state": "CA",
            "postal_code": "956605108",
            "country_code": "US",
            "telephone_number": "916-454-2345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDHI",
        "first_name": "RADHA",
        "middle_name": "VARUN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108959",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RADHA",
            "last_name": "PATEL",
            "middle_name": "GAURANGKUMAR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in W Sacramento, CA
• Providers in W Sacramento, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.