Individual
DR. NIDHI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1050 W BLUE RIDGE BLVD, KANSAS CITY, MO 64145-1216
(913) 669-6129
(913) 281-6405
Mailing address
2340 E MEYER BLVD STE 200, KANSAS CITY, MO 64132-1121
(802) 851-8603
(802) 851-8313
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
2019002294
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2019002294
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014638
—
VT
01
—
1780737627
NPI
MO
05
—
30004631500002
—
KS
05
—
400071252
—
MO
05
—
432249499
—
ME
05
—
47D0660981
—
VT
Enumeration date
01/22/2007
Last updated
01/20/2023
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