Anjana Gupta, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

12011039A Issued in IN

Practice address

505 Vistula St
Elkhart, IN 46516-2809

Phone

(574) 293-2003

Fax

(574) 294-6131

NPI assigned

Jul 27, 2007

Sex

Female

Sole proprietor

No

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 MI

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": "1185494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185494400000",
    "number": "1164612057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 VISTULA ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465162809",
            "telephone_number": "574-293-2003",
            "fax_number": "574-294-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 VISTULA ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465162809",
            "telephone_number": "574-293-2003",
            "fax_number": "574-294-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "ANJANA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-27",
        "last_updated": "2007-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12011039A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn S Groves, NP
• Anne K. Gruber, PA-C
• Ruth Lapp Guengerich
• Kerry M Guernsey
• Alexis Gullett
• Michael B Gural, OD
• David Theophilus Gursky, M.D.
• Destaney Gutierrez
• Yasmine Hadi
• Elaine A. Hagen, RD, CD

• Dentist in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Dentist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2007; 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.