Dr. Shivane K Gupta
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
4150 Five Forks Trickum Rd Sw Suite 1 Www.lipsondentalgroup.com
Lilburn
, Georgia 30047
Dr. Shivane K Gupta
Oral and Maxillofacial Surgeon Oral & Maxillofacial Surgeon
4150 Five Forks Trickum Rd Sw Suite 1 Www.lipsondentalgroup.com
Lilburn
, Georgia 30047
(770) 717-7228
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
- Oral & Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Shivane K Gupta
- 4150 Five Forks Trickum Rd Sw, Suite 1 Lipson Dental Group
- Lilburn, GA
- Zip : 30047-3130
- Fax : (770) 717-7228
- Phone : (770) 717-7225
Second Address
- Dr. Shivane K Gupta
- 4150 Five Forks Trickum Rd Sw Suite 1 Www.lipsondentalgroup.com
- Lilburn, GA
- Zip : 30047
- Phone : (770) 717-7225
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Is Dr. Shivane K Gupta a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | DN014112 | GA |
| N | 204E00000X | Oral & Maxillofacial Surgeon | 078309 | GA |
National Provider Identifier
| NPI | 1295046399 |
|---|---|
| Provider Name | Dr. Shivane K Gupta |
| First Address | Lilburn, GA 30047-3130 |
| Second Address | Lilburn, GA 30047 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/06/2010 |
| Last Update Date | 27/01/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.