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General NPI Number Information
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NPI Number | 1770934846
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Entity Type | Individual
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Provider Name | HEENA GUPTA DDS
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Gender | Female
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Dates
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Enumeration Date | 06/29/2016
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Last Update Date | 02/02/2020
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Provider Practice Location Address
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Address Line | 1241 MISSION RD
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City | SOUTH SAN FRANCISCO
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State | CA
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Zip | 94080-1397
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Country | US
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Telephone | 650-588-3710
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 22ND ST APT 114
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-3832
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 32097
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 103612
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License Number State | CA
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