Active NPI
Taren Pannu
- Dental Hygienist
- Point Richmond, CA
National Provider Identifier
1154893204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- RDHAP714
- Practice address
- 229 Tewksbury Ave Ste a
Point Richmond, CA 94801-3829 - Phone
- (415) 755-5549
- NPI assigned
- Dec 28, 2018
- Last updated
- Dec 28, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | RDHAP714 | CA | Primary |
Addresses
Primary practice location
229 Tewksbury Ave Ste a
Point Richmond, CA 94801-3829
Mailing address
16 Woodstock CT
San Rafael, CA 94903-4619
Phone (415) 755-5549
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RDHAP714 | Other | CA | DHCC |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RDHAP714 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1545955200000",
"number": "1154893204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 WOODSTOCK CT",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949034619",
"telephone_number": "415-755-5549"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "229 TEWKSBURY AVE STE A",
"city": "POINT RICHMOND",
"state": "CA",
"postal_code": "948013829",
"telephone_number": "415-755-5549"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANNU",
"first_name": "TAREN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-12-28",
"last_updated": "2018-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "RDHAP714",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DHCC",
"identifier": "RDHAP714",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Point Richmond, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.