Individual provider Active NPI

Isherpreet Shergill, MD,DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Hurst, TX
National Provider Identifier
1316204696
Registry record updated Apr 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
V8027 Issued in TX
Practice address
613 W Harwood Rd
Hurst, TX 76054-3161
Phone
(817) 268-4108
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38311 TX
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X V8027 TX Primary

Addresses

Primary practice location

613 W Harwood Rd
Hurst, TX 76054-3161

Mailing address

344 Cove Dr
Coppell, TX 75019-5679
Phone (312) 451-9563

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161005001429 IL Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 4486942596

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38311TXMDDentist
V8027TXMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Tarrant County Oral and Maxillofacial Surgery LLC CurrentSince Apr 27, 2025 Accepting new patients

Locations

613 W Harwood Rd
Hurst, TX 76054
Phone (817) 268-4108

Organizations & group practices 1

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1316204696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "344 COVE DR",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750195679",
            "telephone_number": "312-451-9563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "613 W HARWOOD RD",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543161",
            "telephone_number": "817-268-4108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERGILL",
        "first_name": "ISHERPREET",
        "name_prefix": "Dr.",
        "credential": "MD,DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "38311",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "TX",
            "license": "V8027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurst, TX

Sources for this page

Verify at the official NPI Registry.