Surbhi Gupta

Primary specialty

DentistTaxonomy code 122300000X

License

0401417822 Issued in VA

Practice address

215 Bloomingdale Ave
Federalsburg, MD 21632-1012

Phone

(410) 754-9021

NPI assigned

Mar 25, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654387200000",
    "number": "1992332399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 BLOOMINGDALE AVE",
            "city": "FEDERALSBURG",
            "state": "MD",
            "postal_code": "216321012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 BLOOMINGDALE AVE",
            "city": "FEDERALSBURG",
            "state": "MD",
            "postal_code": "216321012",
            "telephone_number": "410-754-9021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "SURBHI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Federalsburg Pharmacy LLC
• Sandra Garbely Kerkovich, DMD
• Golife Mobility LLC
• Mary Gondeck, ATC
• Carmen Sofia Grant, LCSW-C
• Michelle Hammond, CMHC, PHD ,
• John William Hawkins, DDS
• Jennifer L Hubbert
• John a Appiott DO PC
• Tiarra Jones-Bbosa, CRNP

• All providers in Federalsburg, MD
• Dentist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2022; 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.

Verify at the official NPI Registry.