Provider Demographics
NPI:1801153101
Name:HARDY, NAMRATA GUPTE (DMD)
Entity type:Individual
Prefix:DR
First Name:NAMRATA
Middle Name:GUPTE
Last Name:HARDY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:NAMRATA
Other - Middle Name:SUNIL
Other - Last Name:GUPTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3200 VILLAGE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:CO
Mailing Address - Zip Code:80516-2521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3200 VILLAGE VISTA DR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-2521
Practice Address - Country:US
Practice Address - Phone:720-900-3119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002022751223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty