Active NPI
Isha Manan Gandhi, DMD
- Pediatric Dentistry
- Limerick, PA
National Provider Identifier
1679099543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DS043580
- Practice address
- 292 W Ridge Pike Ste a
Limerick, PA 19468-3716 - Phone
- (407) 797-9417
- NPI assigned
- Aug 22, 2017
- Last updated
- Nov 25, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | LL851 | MD | |
| Pediatric Dentistry | 1223P0221X | LL851 | MD | |
| Pediatric Dentistry | 1223P0221X | DS043580 | PA | Primary |
Addresses
Primary practice location
292 W Ridge Pike Ste a
Limerick, PA 19468-3716
Mailing address
PO Box 1978
Salisbury, MD 21802-1978
Phone (410) 749-1015
Other practice location 1
12165 Elm St
Princess Anne, MD 21853-1358
Phone (410) 651-5151
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119591300 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL851 | MD | MD | Pediatric Dentist |
| DS043580 | PA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669334400000",
"number": "1679099543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1978",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218021978",
"telephone_number": "410-749-1015",
"fax_number": "410-749-0654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "292 W RIDGE PIKE STE A",
"city": "LIMERICK",
"state": "PA",
"postal_code": "194683716",
"telephone_number": "407-797-9417"
}
],
"practiceLocations": [
{
"address_1": "12165 Elm St",
"address_purpose": "LOCATION",
"city": "Princess Anne",
"state": "MD",
"postal_code": "218531358",
"country_code": "US",
"telephone_number": "410-651-5151",
"fax_number": "410-651-4256",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GANDHI",
"first_name": "ISHA",
"middle_name": "MANAN",
"name_prefix": "Ms.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-22",
"last_updated": "2022-11-25",
"certification_date": "2022-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "LL851",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MD",
"license": "LL851",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "PA",
"license": "DS043580",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119591300",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Limerick, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.