MEDICARE: AMIT SAPARIA 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	12011381A	IN

General Provider Information

NPI Number	:	1275831059
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMIT SAPARIA DDS INC.

Provider Business Mailing Address
First Line	:	814 W CHICAGO AVE
Second Line	:
City	:	EAST CHICAGO
State	:	IN
Zip	:	46312-3307
Country	:	US
Telephone Number	:	708-359-2068
Fax Number	:

Provider Business Practice Location Address
First Line	:	814 W CHICAGO AVE
Second Line	:
City	:	EAST CHICAGO
State	:	IN
Zip	:	46312-3307
Country	:	US
Telephone Number	:	708-359-2068
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. AMIT SAPARIA
Credential	:	D.D.S.
Telephone Number	:	708-359-2068

Provider Enumeration Date	:	03/03/2011
Last Update Date	:	03/03/2011

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