Provider Demographics
NPI:1508631854
Name:GUPTA, EKTA (DDS)
Entity Type:Individual
Prefix:DR
First Name:EKTA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:991 MONTAGUE EXPY STE 108
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6809
Mailing Address - Country:US
Mailing Address - Phone:408-262-8747
Mailing Address - Fax:
Practice Address - Street 1:991 MONTAGUE EXPY STE 108
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6809
Practice Address - Country:US
Practice Address - Phone:408-262-8747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109424122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist