Provider Demographics
NPI:1376260992
Name:GUPTA, ARJUN (DMD)
Entity type:Individual
Prefix:DR
First Name:ARJUN
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 UNION SQ APT 313
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-8529
Mailing Address - Country:US
Mailing Address - Phone:425-577-2651
Mailing Address - Fax:
Practice Address - Street 1:3147 TELEGRAPH AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3206
Practice Address - Country:US
Practice Address - Phone:425-577-2651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1083001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice