Provider Demographics
NPI:1093589087
Name:PREETIKA GUPTA DDS
Entity Type:Organization
Organization Name:PREETIKA GUPTA DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENYIST
Authorized Official - Prefix:
Authorized Official - First Name:PREETIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-643-3800
Mailing Address - Street 1:1521 STRAIGHT PATH
Mailing Address - Street 2:
Mailing Address - City:WYANDANCH
Mailing Address - State:NY
Mailing Address - Zip Code:11798-3414
Mailing Address - Country:US
Mailing Address - Phone:631-643-3800
Mailing Address - Fax:631-253-4292
Practice Address - Street 1:1521 STRAIGHT PATH
Practice Address - Street 2:
Practice Address - City:WYANDANCH
Practice Address - State:NY
Practice Address - Zip Code:11798-3414
Practice Address - Country:US
Practice Address - Phone:631-643-3800
Practice Address - Fax:631-253-4292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty