Individual provider Active NPI

Preetinder Khehra, DDS

  • Dentist
  • Modesto, CA
National Provider Identifier
1073945226
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
101991 Issued in CA
Practice address
2103 McHenry Ave Ste C
Modesto, CA 95350-3264
Phone
(209) 435-9550
NPI assigned
Jul 30, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 29052 TX
Dentist 122300000X 101991 CA Primary

Addresses

Primary practice location

2103 McHenry Ave Ste C
Modesto, CA 95350-3264

Mailing address

4086 Inniswood PL
Dublin, CA 94568-7419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michael Lopez Dental Corporation Dentist PastSince Jan 17, 2022 Accepting new patients
Affordable El Paso Family Dental Associates PLLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1073945226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4086 INNISWOOD PL",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945687419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2103 MCHENRY AVE STE C",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503264",
            "telephone_number": "209-435-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHEHRA",
        "first_name": "PREETINDER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-30",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29052",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.