Individual provider Active NPI

Sukhwinder Singh Dhall

  • General Practice Dentistry
  • North Highlands, CA
National Provider Identifier
1083195085
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103982 Issued in CA
Practice address
4815 Watt Ave
North Highlands, CA 95660-5108
Phone
(916) 454-2345
NPI assigned
Aug 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 34568 TX
General Practice Dentistry 1223G0001X 103982 CA Primary

Addresses

Primary practice location

4815 Watt Ave
North Highlands, CA 95660-5108

Mailing address

1860 Howe Ave Ste 440
Sacramento, CA 95825-1098
Phone (916) 569-8484

Other practice location 1

1511 S Cooper St
Arlington, TX 76010-4105
Phone (817) 226-4242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20220504002276 CA Order and Referring Only - DentistPractitioner - Dentist 7517354822

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34568TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1083195085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 WATT AVE",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956605108",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1511 S Cooper St",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760104105",
            "country_code": "US",
            "telephone_number": "817-226-4242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DHALL",
        "first_name": "SUKHWINDER SINGH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34568",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Highlands, CA

Sources for this page

Verify at the official NPI Registry.