Provider Demographics
NPI:1356774954
Name:GUPTA, AKANKSHA (BDS)
Entity type:Individual
Prefix:
First Name:AKANKSHA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 BOREN AVENUE
Mailing Address - Street 2:SUITE #1776
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-363-8240
Mailing Address - Fax:206-363-8301
Practice Address - Street 1:901 BOREN AVENUE
Practice Address - Street 2:SUITE #1776
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-363-8240
Practice Address - Fax:206-363-8301
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE608072661223X2210X
MNR580122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X2210XDental ProvidersDentistOrofacial Pain
No122300000XDental ProvidersDentist