Provider Demographics
NPI:1033629894
Name:GUPTA, SWATI (DMD)
Entity type:Individual
Prefix:DR
First Name:SWATI
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12397 SAN JOSE BLVD APT 1240
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-2817
Mailing Address - Country:US
Mailing Address - Phone:352-300-9887
Mailing Address - Fax:
Practice Address - Street 1:3667 CROWN POINT RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-5956
Practice Address - Country:US
Practice Address - Phone:904-592-9823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-06
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN28637122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist