Prafull Das Gupta, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE61212830 Issued in WA

Practice address

239 S Burlington Blvd
Burlington, WA 98233-1708

Phone

(360) 707-5353

NPI assigned

Oct 25, 2021

Last updated

Oct 25, 2021By the provider in NPPES

Sex

Male

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 CT

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

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.

• Community Health and Wellness Center of Greater Torrington Inc

  • Primary Care Clinic/Center
  • Torrington, CT
  • NPI 1356318091
  Medicare reassignment NPD
• Community Health and Wellness Center of Greater Torrington Inc

  • Federally Qualified Health Center (FQHC)
  • Winsted, CT
  • NPI 1902757149
  NPD

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1215691316",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "1101-1473 JOHNSTON RD",
            "city": "WHITE ROCK",
            "state": "BRITISH COLUMBIA",
            "postal_code": "V4B 0A2"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 S BURLINGTON BLVD",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982331708",
            "telephone_number": "360-707-5353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "PRAFULL DAS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-25",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61212830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Darrell Green
• Japjot Singh Grewal, M.D.
• Griffith Sayles, OD, P.C.
• Frank Patrick Gruss, SUDPT
• Maria Guillen
• Jennifer Haffey, CDP
• Haggen, Inc (Haggen Food & Pharmacy, TOP Food & Drug)
• Beth Ann Halvorsen, LMFT
• Kirsten Anna Hammer
• Kathy Seaok Han, DMD

• Dentist in Burlington, WA
• Providers in Burlington, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.