MEDICARE: DR. SWATI GUPTA DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DN28637	FL

General Provider Information

NPI Number	:	1033629894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SWATI GUPTA DMD

Provider Business Mailing Address
First Line	:	12397 SAN JOSE BLVD APT 1240
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32223-2817
Country	:	US
Telephone Number	:	352-300-9887
Fax Number	:

Provider Business Practice Location Address
First Line	:	3667 CROWN POINT RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32257-5956
Country	:	US
Telephone Number	:	904-592-9823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2017
Last Update Date	:	10/06/2025

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