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General NPI Number Information
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NPI Number | 1780737627
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Entity Type | Individual
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Provider Name | NIDHI GUPTA D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 1050 W BLUE RIDGE BLVD
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City | KANSAS CITY
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State | MO
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Zip | 64145-1216
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Country | US
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Telephone | 913-669-6129
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Fax | 913-281-6405
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Provider Business Mailing Address
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Address Line | 2340 E MEYER BLVD STE 200
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City | KANSAS CITY
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State | MO
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Zip | 64132-1121
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Country | US
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Telephone | 802-851-8603
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Fax | 802-851-8313
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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 | 2019002294
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2019002294
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License Number State | MO
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