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General NPI Number Information
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NPI Number | 1255543328
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Entity Type | Individual
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Provider Name | MANISHA GUPTA DMD
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 7180 CASCADE VALLEY CT
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City | LAS VEGAS
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State | NV
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Zip | 89128-0449
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Country | US
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Telephone | 702-735-0833
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Fax |
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Provider Business Mailing Address
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Address Line | 2047 ORCHARD MIST ST
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City | LAS VEGAS
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State | NV
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Zip | 89135-1561
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Country | US
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Telephone | 702-202-8293
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5104
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License Number State | NV
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