Active NPI
Vidushi Gupta, D.M.D
- Periodontics
- Meriden, CT
National Provider Identifier
1790212348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 12796
- Practice address
- 546 S Broad St Ste 2D
Meriden, CT 06450-6601 - Phone
- (203) 630-1312
- NPI assigned
- May 15, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Periodontics | 1223P0300X | 12796 | CT | Primary |
Addresses
Primary practice location
546 S Broad St Ste 2D
Meriden, CT 06450-6601
Mailing address
546 S Broad St Ste 2D
Meriden, CT 06450-6601
Phone (203) 630-1312
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12796 | CT | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1494806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1637712000000",
"number": "1790212348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "546 S BROAD ST STE 2D",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064506601",
"telephone_number": "203-630-1312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "546 S BROAD ST STE 2D",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064506601",
"telephone_number": "203-630-1312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "VIDUSHI",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-15",
"last_updated": "2021-11-24",
"certification_date": "2021-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CT",
"license": "12796",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meriden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.