Active NPI
Manreet Grewal, D.D.S.
- General Practice Dentistry
- Costa Mesa, CA
National Provider Identifier
1184825820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 58993
- Practice address
- 1700 Adams Ave Ste 104
Costa Mesa, CA 92626-4865 - Phone
- (714) 545-0429
- Fax
- (714) 545-0420
- NPI assigned
- May 30, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 58993 | CA | Primary |
Addresses
Primary practice location
1700 Adams Ave Ste 104
Costa Mesa, CA 92626-4865
Mailing address
1700 Adams Ave Ste 104
Costa Mesa, CA 92626-4865
Phone (949) 278-2207
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 |
|---|---|---|---|
| 58993 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mahadeep Virk, DMD-Bremerton PS | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Bremerton, WA
- NPI 1154537280
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594944000000",
"number": "1184825820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 ADAMS AVE STE 104",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926264865",
"telephone_number": "949-278-2207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 ADAMS AVE STE 104",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926264865",
"telephone_number": "714-545-0429",
"fax_number": "714-545-0420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREWAL",
"first_name": "MANREET",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-30",
"last_updated": "2020-07-17",
"certification_date": "2020-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "58993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.