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DR. SHIVANE K GUPTA MD
NPI 1295046399
Oral & Maxillofacial Surgery in Lilburn, GA

Active since June 24, 2010
4150 FIVE FORKS TRICKUM RD SW STE 1, LILBURN, GA 30047(770) 717-7225(770) 717-7228 Get Directions Write a Review

NPPES record last updated: July 6, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 6, 2022, Jan 27, 2019, Jul 16, 2017 (3 updates tracked since 2017).

About Dr. Shivane K Gupta Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHIVANE K GUPTA MD (NPI 1295046399) is an individual oral & maxillofacial surgery provider in Lilburn, Georgia, licensed in Georgia (078309) and active in the NPI registry since June 2010.

NPPES Registry Identity

NPI1295046399
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. SHIVANE K GUPTACredential: MD
Location Address4150 FIVE FORKS TRICKUM RD SW STE 1Lilburn, GA 30047-3130
Mailing Address4150 Five Forks Trickum Rd Sw Ste 1Lilburn, GA 30047-3130 · (770) 717-7225 · Fax (770) 717-7228
Phone(770) 717-7225
Fax(770) 717-7228
Sole ProprietorYes
Enumeration DateJune 24, 2010
Last NPPES UpdateJuly 6, 20223 updates tracked since enumeration
NPPES CertifiedJuly 6, 2022
✔ NPI 1295046399 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in GA · 078309
Definition
Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.
4150 FIVE FORKS TRICKUM RD SW STE 1, Lilburn, GA 30047
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shivane Gupta's NPI number?

The NPI number for Shivane Gupta is 1295046399. It was assigned to this individual provider in the NPPES registry on June 24, 2010.

Where is Shivane Gupta located?

Shivane Gupta practices at 4150 Five Forks Trickum Rd SW Ste 1, Lilburn, GA 30047. The listed phone number is (770) 717-7225.

What is Shivane Gupta's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

When was this NPI record last updated?

The NPPES record for Shivane Gupta was last updated on July 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.