Pannu and Henne Dental Corp.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PANNU AND HENNE DENTAL CORP.

Practice address

3219 MC Henry Ave, Suite E
Modesto, CA 95350

Phone

(209) 409-8987

Fax

(209) 322-4749

NPI assigned

Sep 27, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dalvir S Pannu, DDS

Title

Owner & Partner Dentist

Phone

(408) 826-1144

Specialties & licenses 1

Addresses

Other names 1

• Great Smiles Dental Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1506470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506470400000",
    "number": "1053820522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3219 MC HENRY AVE, SUITE E",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-409-8987",
            "fax_number": "209-322-4749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3219 MC HENRY AVE, SUITE E",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-409-8987",
            "fax_number": "209-322-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANNU AND HENNE DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-27",
        "last_updated": "2017-09-27",
        "status": "A",
        "authorized_official_last_name": "PANNU",
        "authorized_official_first_name": "DALVIR",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER & PARTNER DENTIST",
        "authorized_official_telephone_number": "408-826-1144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Great Smiles Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rosalie Irene Paniagua Gamaza
• Sophea Pann, RN
• Divya Pannala, M.D.
• Jeremy Pannell II
• Melody Pannell, LCSW
• Sumeet Pannu
• Varinder Pannu
• Kristen Noel Panou
• Celeste Ujuraviht Pantoja Morales
• Jazmine Pantoja

• Dentist in Modesto, CA
• Providers in Modesto, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.