Provider Demographics
NPI:1750916029
Name:GUPTA, BAOHIEN NGOCCHU (RDH,BS)
Entity type:Individual
Prefix:
First Name:BAOHIEN
Middle Name:NGOCCHU
Last Name:GUPTA
Suffix:
Gender:F
Credentials:RDH,BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1071 PIPESTEM PL
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20854-5511
Mailing Address - Country:US
Mailing Address - Phone:301-728-5715
Mailing Address - Fax:
Practice Address - Street 1:8120 WOODMONT AVE STE 110
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2743
Practice Address - Country:US
Practice Address - Phone:301-657-9116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-07
Last Update Date:2020-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6551124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist