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Active NPI 1104104512 Individual Practitioner Male Practitioner

Vikram Ganupur

Dentist - General Practice • Clovis, NM

Professional Overview & Biography Verified Profile Summary

Vikram Ganupur is a registered healthcare professional specializing in Dentist - General Practice in Clovis, NM. Practice services are available at 4017 N PRINCE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4017 N Prince St

Clovis, NM 881019705

Telephone 8479153040
Associated Practice Facility / Clinic
🏢 Familia Dentalclovis Llc Facility NPI 1841583291

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Clovis, NM

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 9.6 Yrs
Regional Practice Density
20 Specialists

Practicing in Clovis, NM (761 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License NM DD3568

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
NPI 1053891150

Doctor of Dental Surgery

NPI 1104554203

Doctor of Dental Surgery

NPI 1134934672

Doctor of Dental Surgery

Dr. Ajneesh Chhabra , DDS

Dentist - General Practice

NPI 1255687844

Doctor of Dental Surgery

NPI 1275265928

Doctor of Dental Surgery

Dr. Kirankumar Tamminidi , DMD

Dentist - General Practice

NPI 1437404407

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 02, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location August 02, 2011

Registered at 4017 N PRINCE ST, CLOVIS, NM 881019705 (Tel: 8479153040)

📍
Updated Business Mailing Address August 02, 2011

Registered at 2610 WEDDINGTON RDG NE, MARIETTA, GA 300682279 (Tel: 6789231486)

👤
Provider Name / Credentials Updated August 02, 2011

Recorded as VIKRAM GANUPUR

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 02, 2011

Dentist (License #DD3568 in NM)

🟢
Initial NPI Registration & Enumeration August 02, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104104512
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 02, 2011
Last Update: August 02, 2011
Sole Proprietor: Yes

Mailing Address

2610 Weddington Rdg Ne

Marietta, GA 300682279

Phone: 6789231486

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.