Individual provider Active NPI

Gurjit Singh Randhawa, D.D.S., M.D.S.

  • Dentist
  • Alameda, CA
National Provider Identifier
1265640379
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46941 Issued in CA
Practice address
2229 Santa Clara Ave Ste E
Alameda, CA 94501-4409
Phone
(510) 521-3300
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 46941 CA Primary
General Practice Dentistry 1223G0001X 46941 CA

Addresses

Primary practice location

2229 Santa Clara Ave Ste E
Alameda, CA 94501-4409

Mailing address

2229 Santa Clara Ave Ste E
Alameda, CA 94501-4409
Phone (510) 521-3300

Other practice location 1

5901 Christie Ave Ste 106
Emeryville, CA 94608-1952
Phone (510) 658-9775

Other practice location 2

41 Admiral Callaghan Ln Ste E
Vallejo, CA 94591-4000
Phone (707) 552-3816

Other practice location 3

3435 Chestnut Ave
Concord, CA 94519-2415
Phone (925) 685-8994

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
46941CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Gurjit Randhawa Dental Practice Inc Current Accepting new patients
Gurjit S Randhwa DDS, Inc. CurrentSince Mar 20, 2022 Accepting new patients
G.S. Randhawa D.D.S., Inc. General Practice CurrentSince Jan 26, 2020 Accepting new patients
Gurjit Randhawa Dental, Inc. Current Accepting new patients
Vincent Lim, DDS, Inc Dentist Past Accepting new patients

Locations

2229 Santa Clara Ave
Ste E
Alameda, CA 94501
Phone (510) 521-3300

5901 Christie Ave
Ste 106
Emeryville, CA 94608
Phone (509) 626-9900

Organizations & group practices 5

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": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1265640379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2229 SANTA CLARA AVE STE E",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014409",
            "telephone_number": "510-521-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2229 SANTA CLARA AVE STE E",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945014409",
            "telephone_number": "510-521-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 Christie Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Emeryville",
            "state": "CA",
            "postal_code": "946081952",
            "country_code": "US",
            "telephone_number": "510-658-9775",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Admiral Callaghan Ln Ste E",
            "address_purpose": "LOCATION",
            "city": "Vallejo",
            "state": "CA",
            "postal_code": "945914000",
            "country_code": "US",
            "telephone_number": "707-552-3816",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3435 Chestnut Ave",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945192415",
            "country_code": "US",
            "telephone_number": "925-685-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDHAWA",
        "first_name": "GURJIT",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46941",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46941",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 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.

Verify at the official NPI Registry.