Siddharth Gupta, BDS,MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

24143 Issued in TX

Practice address

12319 N Mopac Expy Ste 160
Austin, TX 78758-2648

Phone

(512) 222-5721

NPI assigned

Aug 7, 2008

Last updated

Jul 20, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Periodontists PC

  • Periodontics
  • Austin, TX
  • NPI 1467132159
  NPD
• Kyleen J Chen, D.D.S., P.C.

  dba KC Dental

  • General Practice Dentistry
  • Austin, TX
  • NPI 1750591392
  NPD (past)

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595203200000",
    "number": "1013163260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12319 N MOPAC EXPY STE 160",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582648",
            "telephone_number": "512-222-5721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12319 N MOPAC EXPY STE 160",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582648",
            "telephone_number": "512-222-5721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6301 W Parmer Ln",
            "address_2": "Suite 606",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787296801",
            "country_code": "US",
            "telephone_number": "512-918-0888",
            "fax_number": "512-918-0886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SIDDHARTH",
        "name_prefix": "Dr.",
        "credential": "BDS,MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-07",
        "last_updated": "2020-07-20",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "24143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neal Gupta, MD
• Rajat Gupta, M.D.
• Samir Gupta, DDS
• Seema Gupta, M.D.
• Shailee Jitendra Gupta, DDS, MPH
• Manjusha Arun Gupte, MD
• Holly Marie Gureski, APRN
• Megan Gurney, PT, DPT
• Priyanka Gurru
• Donna Ann Gurschke

• Periodontics in Austin, TX
• Providers in Austin, TX by specialty
• Periodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2020; 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.