Organization Active NPI

Pardeep Kaur DDS PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Chesapeake, VA
National Provider Identifier
1285355388
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
PARDEEP KAUR DDS PLLC
Practice address
548 Battlefield Blvd S
Chesapeake, VA 23322-5363
Phone
(757) 681-8181
NPI assigned
Sep 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Authorized official

Name
Pardeep KaurNPI 1679867824
Title
Owner
Phone
(757) 681-8181

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

548 Battlefield Blvd S
Chesapeake, VA 23322-5363

Mailing address

2140 Great Neck SQ
Virginia Beach, VA 23454-2202
Phone (757) 681-8181

Other practice location 1

2140 Great Neck Sq
Virginia Beach, VA 23454-2202
Phone (757) 681-8181

Other identifiers 2

IdentifierTypeStateIssuer
1679867824OtherINDIVIDUAL NPI
040141574OtherVADENTAL LICENSE

Other names 2

  • Coastal Orthodontics Doing business as
  • Wexel Orthodontics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220808000568 VA DME Supplier - Oral Surgery - Dentist 3476935404 Practice locations: Virginia Beach, VA

National Provider Directory

National Provider Directory

Locations

2140 Great Neck Sq
Virginia Beach, VA 23454
Phone (757) 681-8181

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691107200000",
    "number": "1285355388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 GREAT NECK SQ",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234542202",
            "telephone_number": "757-681-8181",
            "fax_number": "757-900-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 BATTLEFIELD BLVD S",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225363",
            "telephone_number": "757-681-8181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2140 Great Neck Sq",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234542202",
            "country_code": "US",
            "telephone_number": "757-681-8181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PARDEEP KAUR DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2023-08-04",
        "certification_date": "2023-08-04",
        "status": "A",
        "authorized_official_last_name": "KAUR",
        "authorized_official_first_name": "PARDEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-681-8181"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1679867824",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "040141574",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wexel Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.