MEDICARE: DR. GARIMA GUPTA DDS

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	1223P0221X	Pediatric Dentistry	16743	MD

General Provider Information

NPI Number	:	1548515836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARIMA GUPTA DDS

Provider Business Mailing Address
First Line	:	7360 GUILFORD DR STE 102
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21704-5128
Country	:	US
Telephone Number	:	415-578-8980
Fax Number	:

Provider Business Practice Location Address
First Line	:	7360 GUILFORD DR STE 102
Second Line	:
City	:	FREDERICK
State	:	MD
Zip	:	21704-5128
Country	:	US
Telephone Number	:	415-578-8980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2012
Last Update Date	:	05/04/2021

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