Provider Demographics
NPI:1043488117
Name:GUPTA, ARUN KUMAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ARUN
Middle Name:KUMAR
Last Name:GUPTA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3228 OCTOBER CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-0908
Mailing Address - Country:US
Mailing Address - Phone:951-278-1931
Mailing Address - Fax:909-355-2715
Practice Address - Street 1:11623 CHERRY AVE STE B2
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92337-1212
Practice Address - Country:US
Practice Address - Phone:909-355-1485
Practice Address - Fax:909-355-2715
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-12
Last Update Date:2008-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA568171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice