Provider Demographics
NPI:1467861773
Name:UPPAL, ANNA GILL (DDS)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:GILL
Last Name:UPPAL
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 1:3581 TERRA ALTA DR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9373
Mailing Address - Country:US
Mailing Address - Phone:408-387-3113
Mailing Address - Fax:916-983-3334
Practice Address - Street 1:1568 CREEKSIDE DR STE 101
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-3449
Practice Address - Country:US
Practice Address - Phone:408-387-3113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-12
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104380122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist