Provider Demographics
NPI:1629290960
Name:REENA GUPTA DDS INC
Entity Type:Organization
Organization Name:REENA GUPTA DDS INC
Other - Org Name:SMILEY DOCTOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:REENA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:408-247-4100
Mailing Address - Street 1:373 S MONROE ST
Mailing Address - Street 2:ST 203
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-5103
Mailing Address - Country:US
Mailing Address - Phone:408-247-4100
Mailing Address - Fax:650-230-7114
Practice Address - Street 1:373 S MONROE ST
Practice Address - Street 2:ST 203
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-5103
Practice Address - Country:US
Practice Address - Phone:408-247-4100
Practice Address - Fax:650-230-7114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty