Individual provider Active NPI

Inderpreet Atwal, DDS

  • Dentist
  • North Syracuse, NY
National Provider Identifier
1346579612
Registry record updated Feb 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
056392 Issued in NY
Practice address
501 S Main St
North Syracuse, NY 13212-2813
Phone
(315) 452-1020
NPI assigned
Dec 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 056392 NY Primary

Addresses

Primary practice location

501 S Main St
North Syracuse, NY 13212-2813

Mailing address

501 S Main St
North Syracuse, NY 13212-2813
Phone (315) 452-1020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20210309000868 NY Practitioner - Dentist 7214228782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
New York University College of Dentistry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

501 S Main St
North Syracuse, NY 13212-2813
Phone (315) 214-5912

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
056392NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Atwal Sleep & Wellness LLC CurrentSince Oct 30, 2020 Accepting new patients
Dr Ramakumar Suryadevara Dentist PastSince Oct 30, 2020 Accepting new patients

Locations

501 S Main St
Syracuse, NY 13212
Phone (315) 214-5912

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": "1260921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1346579612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S MAIN ST",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122813",
            "telephone_number": "315-452-1020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 S MAIN ST",
            "city": "NORTH SYRACUSE",
            "state": "NY",
            "postal_code": "132122813",
            "telephone_number": "315-452-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWAL",
        "first_name": "INDERPREET",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-16",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "056392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Syracuse, NY

Sources for this page

Verify at the official NPI Registry.