Individual provider Active NPI

Pooja Gupta, D.D.S

  • General Practice Dentistry
  • Westborough, MA
National Provider Identifier
1407009194
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
05120 Issued in NH
Practice address
2400 Computer Dr
Westborough, MA 01581-1770
Phone
(508) 329-2250
NPI assigned
Oct 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22321 MA
General Practice Dentistry 1223G0001X 05120 NH Primary

Addresses

Primary practice location

2400 Computer Dr
Westborough, MA 01581-1770

Mailing address

700 Lake Ave
Manchester, NH 03103-2734
Phone (603) 668-0227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20161115000522 MA Order and Referring Only - DentistPractitioner - Dentist 1355620329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22321MAMDGeneral Practice Dentistry
05120NHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
White Birch Family Dental, P.C Current Accepting new patients
Advantage Dental Oral Health Center of Massachusetts, PC General Practice PastSince Sep 25, 2019 Accepting new patients

Locations

700 Lake Ave
Manchester, NH 03103
Phone (603) 622-3020

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1407009194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 LAKE AVE",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031032734",
            "telephone_number": "603-668-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 COMPUTER DR",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015811770",
            "telephone_number": "508-329-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "POOJA",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "22321",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "05120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

Verify at the official NPI Registry.