Individual provider Active NPI

Virinder S Grewal, DMD

  • General Practice Dentistry
  • Elk Grove, CA
National Provider Identifier
1194908103
Registry record updated Jun 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44315 Issued in CA
Practice address
9571 Laguna Springs Dr
Suite # 100
Elk Grove, CA 95758-7961
Phone
(916) 683-1800
Fax
(916) 683-1890
NPI assigned
Dec 12, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 44315 CA Primary

Addresses

Primary practice location

9571 Laguna Springs Dr
Suite # 100
Elk Grove, CA 95758-7961

Mailing address

9571 Laguna Springs Dr
Suite # 100
Elk Grove, CA 95758-7961
Phone (916) 683-1800

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

LicenseStateTypeSpecialty
44315CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
V.S.Grewal,DMD Professional Dental Corp 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.

NPI Registry JSON

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

{
    "created_epoch": "1197417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403222400000",
    "number": "1194908103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9571 LAGUNA SPRINGS DR",
            "address_2": "SUITE # 100",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587961",
            "telephone_number": "916-683-1800",
            "fax_number": "916-683-1890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9571 LAGUNA SPRINGS DR",
            "address_2": "SUITE # 100",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587961",
            "telephone_number": "916-683-1800",
            "fax_number": "916-683-1890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "VIRINDER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-12-12",
        "last_updated": "2014-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.