Individual provider Active NPI

Deepak Gupta, D.M.D.

  • General Practice Dentistry
  • Savannah, GA
National Provider Identifier
1821229808
Registry record updated Aug 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013967 Issued in GA
Practice address
207 E 31St St
Savannah, GA 31401-7304
Phone
(912) 232-2779
Fax
(912) 236-1962
NPI assigned
Aug 7, 2009
Last updated
Aug 7, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN013967 GA Primary

Addresses

Primary practice location

207 E 31St St
Savannah, GA 31401-7304

Mailing address

207 E 31St St
Savannah, GA 31401-7304
Phone (912) 232-2779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160617000949 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3971894148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN013967GAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Morrison Dental Associates, P.C. Past Accepting new patients

Organizations & group practices 1

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": "1249603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249603200000",
    "number": "1821229808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 E 31ST ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314017304",
            "telephone_number": "912-232-2779",
            "fax_number": "912-236-1962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E 31ST ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314017304",
            "telephone_number": "912-232-2779",
            "fax_number": "912-236-1962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "DEEPAK",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-07",
        "last_updated": "2009-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.