Individual provider Active NPI

Gursimran Kaur Bhangra

  • Dentist
  • Gainesville, VA
National Provider Identifier
1073000139
Registry record updated Apr 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401415905 Issued in VA
Practice address
8140 Stonewall Shops SQ
Gainesville, VA 20155-3891
Phone
(571) 298-8279
NPI assigned
Apr 15, 2018
Last updated
Apr 15, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401415905 VA Primary

Addresses

Primary practice location

8140 Stonewall Shops SQ
Gainesville, VA 20155-3891

Mailing address

42201 Dove Wing CT
Brambleton, VA 20148-8092
Phone (703) 585-5236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190116000081 VA Order and Referring Only - DentistPractitioner - Dentist 6406192277

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bhangra Enterprises PLLC Current Accepting new patients
Dentists of Gainesville, PC Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523750400000",
    "number": "1073000139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42201 DOVE WING CT",
            "city": "BRAMBLETON",
            "state": "VA",
            "postal_code": "201488092",
            "telephone_number": "703-585-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 STONEWALL SHOPS SQ",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201553891",
            "telephone_number": "571-298-8279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BHANGRA",
        "first_name": "GURSIMRAN",
        "middle_name": "KAUR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2018-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401415905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, VA

Sources for this page

Verify at the official NPI Registry.