Individual provider Active NPI

Sonia Grewal, D.D.S

  • General Practice Dentistry
  • Lamar, CO
National Provider Identifier
1295990638
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9716 Issued in CO
Practice address
200 Kendall Dr
Lamar, CO 81052-3940
Phone
(719) 336-0261
Fax
(719) 336-0265
NPI assigned
Jul 24, 2008
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 9716 CO Primary

Addresses

Primary practice location

200 Kendall Dr
Lamar, CO 81052-3940

Mailing address

201 Kendall Dr
Lamar, CO 81052-3939
Phone (719) 336-0261

Other identifiers 1

IdentifierTypeStateIssuer
92428363MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150717000697 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9638482870

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9716COMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: sonia.grewal@hpchc.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1295990638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 KENDALL DR",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810523939",
            "telephone_number": "719-336-0261",
            "fax_number": "719-336-0261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 KENDALL DR",
            "city": "LAMAR",
            "state": "CO",
            "postal_code": "810523940",
            "telephone_number": "719-336-0261",
            "fax_number": "719-336-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "SONIA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "9716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92428363",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lamar, CO

Sources for this page

Verify at the official NPI Registry.