Individual provider Active NPI

Kirandeep Brar

  • Dentist
  • Vancouver, WA
National Provider Identifier
1295191732
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60634985 Issued in WA
Practice address
19005 SE 34TH St
Vancouver, WA 98683-1450
Phone
(360) 726-6730
Fax
(360) 726-6731
NPI assigned
Jan 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS040563 PA
General Practice Dentistry 1223G0001X DE60634985 WA
Dentist 122300000X DE60634985 WA Primary

Addresses

Primary practice location

19005 SE 34TH St
Vancouver, WA 98683-1450

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other practice location 1

520 School Way
Louisville, KY 40214-1335
Phone (505) 206-2878

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160914000673 WA Order and Referring Only - DentistPractitioner - Dentist 6507152733

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DS040563PAMDDentist

Interoperability endpoints

  • Direct secure messaging: kbrar452641@direct.multicare.org

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1295191732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19005 SE 34TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986831450",
            "telephone_number": "360-726-6730",
            "fax_number": "360-726-6731"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 School Way",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402141335",
            "country_code": "US",
            "telephone_number": "505-206-2878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRAR",
        "first_name": "KIRANDEEP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040563",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60634985",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60634985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.