Active NPI
Jaskaren Randhawa, DMD
- Dentist
- New York, NY
National Provider Identifier
1285044735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 0582191
- Practice address
- 1501 Broadway
#502
New York, NY 10036-5601 - Phone
- (212) 575-7740
- NPI assigned
- May 6, 2014
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 0582191 | NY | Primary |
Addresses
Primary practice location
1501 Broadway
#502
New York, NY 10036-5601
Mailing address
1501 Broadway
#502
New York, NY 10036-5601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04289305 | Medicaid | NY |
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 |
|---|---|---|---|
| 0582191 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399334400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485043200000",
"number": "1285044735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 BROADWAY",
"address_2": "#502",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100365601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 BROADWAY",
"address_2": "#502",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100365601",
"telephone_number": "212-575-7740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDHAWA",
"first_name": "JASKAREN",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-06",
"last_updated": "2017-01-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "0582191",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04289305",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.