Individual provider Active NPI

Rumpa Ganguly, D.M.D.

  • Oral and Maxillofacial Radiology Dentistry
  • Acton, MA
National Provider Identifier
1699162677
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
DN1856297 Issued in MA
Practice address
30 Brucewood Rd
Acton, MA 01720-4422
Phone
(978) 266-2723
NPI assigned
Apr 17, 2015
Last updated
Apr 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Radiology Dentistry 1223X0008X DN1856297 MA Primary

Addresses

Primary practice location

30 Brucewood Rd
Acton, MA 01720-4422

Mailing address

30 Brucewood Rd
Acton, MA 01720-4422
Phone (978) 266-2723

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201022003889 CA Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 2062832488 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1856297MAMDOral and Maxillofacial Radiology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Medical Group Business Services CurrentSince Sep 24, 2020 Accepting new patients
UCSF Oral Medicine Clinic CurrentSince Sep 24, 2020 Accepting new patients
UCSF Medical Group Business Services CurrentSince Sep 24, 2020 Accepting new patients
UCSF Oral & Maxillofacial Surgery CurrentSince Sep 24, 2020 Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

513 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-1239

513 Parnassus Ave
Rm S722
San Francisco, CA 94143
Phone (415) 476-2045

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1429228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1699162677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BRUCEWOOD RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204422",
            "telephone_number": "978-266-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BRUCEWOOD RD",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204422",
            "telephone_number": "978-266-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANGULY",
        "first_name": "RUMPA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-17",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "MA",
            "license": "DN1856297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

Verify at the official NPI Registry.