Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Shivane K Gupta, MD

Individual provider Oral & Maxillofacial Surgery (D.M.D.) · NPI 1295046399

Dr. Shivane K Gupta, MD is an Oral & Maxillofacial Surgery (D.M.D.) in Lilburn, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

4150 Five Forks Trickum Rd SW Ste 1
Lilburn, GA 30047-3130
Phone: (770) 717-7225
Fax: (770) 717-7228
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral & Maxillofacial Surgery (D.M.D.) (primary) Taxonomy 204E00000X · Licence 078309 (GA)

Record details

NPI number1295046399
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedJune 24, 2010
Last updated in NPPESJuly 6, 2022
Certification dateJuly 6, 2022
Mailing address4150 Five Forks Trickum Rd Sw Ste 1, Lilburn, GA 30047-3130