Active NPI
Joseph Gupana, D.M.D.
- Endodontics
- Philadelphia, PA
National Provider Identifier
1497994917
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DS037540
- Practice address
- 3223 N Broad St
Philadelphia, PA 19140-5007 - Phone
- (630) 779-7143
- NPI assigned
- Feb 5, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DS037540 | PA | Primary |
Addresses
Primary practice location
3223 N Broad St
Philadelphia, PA 19140-5007
Mailing address
3223 N Broad St
Philadelphia, PA 19140-5007
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161011002154 | IL | Order and Referring Only - Other (Physician) | 5597053397 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS037540 | PA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233792000000",
"number": "1497994917",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3223 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3223 N BROAD ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191405007",
"telephone_number": "630-779-7143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPANA",
"first_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-02-05",
"last_updated": "2009-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "PA",
"license": "DS037540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2009; 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.