Individual provider Active NPI

Yadvinder Singh Bhullar

  • Dentist
  • Pinole, CA
National Provider Identifier
1336651587
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
102018 Issued in CA
Practice address
1208 Fitzgerald Dr
Pinole, CA 94564-2252
Phone
(510) 210-8907
NPI assigned
Oct 27, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 102018 CA Primary

Addresses

Primary practice location

1208 Fitzgerald Dr
Pinole, CA 94564-2252

Mailing address

3535 El Portal Dr Apt H110
El Sobrante, CA 94803-2782
Phone (925) 963-6471

Other practice location 1

3535 El Portal Dr
El Sobrante, CA 94803-2740
Phone (925) 963-6471

Other identifiers 1

IdentifierTypeStateIssuer
102018OtherCADENTAL BOARD OF CALIFORNIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180326002033 CA Order and Referring Only - DentistPractitioner - Dentist 8022370386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102018CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Yadvinder Bhullar DDS Inc Single Specialty Current Accepting new patients
Priya Patel Dental Corporation Dentist Past Accepting new patients

Organizations & group practices 2

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": "1509062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1336651587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 EL PORTAL DR APT H110",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "948032782",
            "telephone_number": "925-963-6471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1208 FITZGERALD DR",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642252",
            "telephone_number": "510-210-8907"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 El Portal Dr",
            "address_purpose": "LOCATION",
            "city": "El Sobrante",
            "state": "CA",
            "postal_code": "948032740",
            "country_code": "US",
            "telephone_number": "925-963-6471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHULLAR",
        "first_name": "YADVINDER SINGH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "102018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BOARD OF CALIFORNIA",
            "identifier": "102018",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

Verify at the official NPI Registry.