MEDICARE: ANNA GILL UPPAL DDS INC

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	:	1053272393
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANNA GILL UPPAL DDS INC

Provider Business Mailing Address
First Line	:	5030 LAGUNA BLVD STE 108
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-4149
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5030 LAGUNA BLVD STE 108
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-4149
Country	:	US
Telephone Number	:	916-684-4888
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANNA GILL UPPAL
Credential	:
Telephone Number	:	916-684-4888

Provider Enumeration Date	:	11/18/2025
Last Update Date	:	11/18/2025

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