MEDICARE: DIKSHA THAPA DMD PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1205772902
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIKSHA THAPA DMD PLLC

Provider Business Mailing Address
First Line	:	9840 HAGGERTY RD
Second Line	:
City	:	VAN BUREN TOWNSHIP
State	:	MI
Zip	:	48111-3443
Country	:	US
Telephone Number	:	734-697-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	9840 HAGGERTY RD
Second Line	:
City	:	VAN BUREN TOWNSHIP
State	:	MI
Zip	:	48111-3443
Country	:	US
Telephone Number	:	734-697-4400
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DIKSHA THAPA
Credential	:	DMD
Telephone Number	:	734-697-4400

Provider Enumeration Date	:	04/25/2026
Last Update Date	:	04/25/2026

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