Individual provider Active NPI

Anna Gill Uppal, DDS

  • Dentist
  • Folsom, CA
National Provider Identifier
1467861773
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
104380 Issued in CA
Practice address
1568 Creekside Dr Ste 101
Folsom, CA 95630-3449
Phone
(408) 387-3113
NPI assigned
Aug 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 104380 CA Primary

Addresses

Primary practice location

1568 Creekside Dr Ste 101
Folsom, CA 95630-3449

Mailing address

3581 Terra Alta Dr
El Dorado Hills, CA 95762-9373
Phone (408) 387-3113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210917000784 CA Order and Referring Only - DentistPractitioner - Dentist 4880091883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anna Gill Uppal DDS Inc Current Accepting new patients
Anna G Uppal DDS Corp CurrentSince Oct 23, 2022 Accepting new patients
Peb Dental DDS PA Past Accepting new patients

Locations

1568 Creekside Dr
Ste 101
Folsom, CA 95630
Phone (408) 387-3113

Organizations & group practices 3

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": "1407801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1467861773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3581 TERRA ALTA DR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629373",
            "telephone_number": "408-387-3113",
            "fax_number": "916-983-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 CREEKSIDE DR STE 101",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303449",
            "telephone_number": "408-387-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UPPAL",
        "first_name": "ANNA",
        "middle_name": "GILL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-12",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.