Individual provider Active NPI

Kabir Ram Sandhu, D.M.D

  • Dentist
  • Riverside, CA
National Provider Identifier
1184052482
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63061 Issued in CA
Practice address
6886 Indiana Ave
Suite B
Riverside, CA 92506
Phone
(951) 686-2565
Fax
(951) 686-4565
NPI assigned
Oct 23, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63061 CA Primary

Addresses

Primary practice location

6886 Indiana Ave
Suite B
Riverside, CA 92506

Mailing address

6886 Indiana Ave
Suite B
Riverside, CA 92506
Phone (951) 686-2565

Other names 1

  • Dr. Kabir Sandhu Ram Former name

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
I20150828000521 CA Order and Referring Only - DentistPractitioner - Dentist 8022324599

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1184052482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6886 INDIANA AVE",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "951-686-2565",
            "fax_number": "951-686-4565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6886 INDIANA AVE",
            "address_2": "SUITE B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "92506",
            "telephone_number": "951-686-2565",
            "fax_number": "951-686-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "KABIR",
        "middle_name": "RAM",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-23",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KABIR",
            "last_name": "RAM",
            "middle_name": "SANDHU",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

Verify at the official NPI Registry.