NPIMap

Organization Active NPI

Johal and Ghazal Dental Corporation

Doing business as Elk Grove Dental Group

  • General Practice Dentistry
  • Elk Grove, CA
National Provider Identifier
1114109386
Registry record updated Nov 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
JOHAL AND GHAZAL DENTAL CORPORATION
Doing business as
Elk Grove Dental Group
Practice address
9640 Bruceville Rd
Suite 101
Elk Grove, CA 95757-5950
Phone
(916) 686-9030
Fax
(916) 686-9033
NPI assigned
Nov 29, 2007
Last updated
Nov 29, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2007

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

Authorized official

Name
Dr. Inaksh Johal, DDSNPI 1528264173
Title
Contracts Administrator
Phone
(916) 686-9030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

9640 Bruceville Rd
Suite 101
Elk Grove, CA 95757-5950

Mailing address

2860 Michelle
2ND Floor
Irvine, CA 92606-1009
Phone (714) 508-3600

Other names 1

  • ELK GROVE DENTAL GROUP Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2342977Elk Grove Dental Group9640 Bruceville Rd #101, Elk Grove, CA 95757Certificate of waiverApr 28, 2028

National Provider Directory

National Provider Directory

Locations

9640 Bruceville Rd
Ste 101
Elk Grove, CA 95757
Phone (916) 686-9030

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196294400000",
    "number": "1114109386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 MICHELLE",
            "address_2": "2ND FLOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061009",
            "telephone_number": "714-508-3600",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 BRUCEVILLE RD",
            "address_2": "SUITE 101",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957575950",
            "telephone_number": "916-686-9030",
            "fax_number": "916-686-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHAL AND GHAZAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-29",
        "last_updated": "2007-11-29",
        "status": "A",
        "authorized_official_last_name": "JOHAL",
        "authorized_official_first_name": "INAKSH",
        "authorized_official_title_or_position": "CONTRACTS ADMINISTRATOR",
        "authorized_official_telephone_number": "916-686-9030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELK GROVE DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.