Individual provider Active NPI

Sandeep Randhawa, DDS

  • General Practice Dentistry
  • Brooklyn, NY
National Provider Identifier
1386137263
Registry record updated Nov 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
060517 Issued in NY
Practice address
9323 Avenue L
Brooklyn, NY 11236-4806
Phone
(718) 763-0505
NPI assigned
Jun 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2019

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 060517 NY Primary

Addresses

Primary practice location

9323 Avenue L
Brooklyn, NY 11236-4806

Mailing address

9323 Avenue L
Brooklyn, NY 11236-4806
Phone (718) 763-0505

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
I20190211002971 NY Order and Referring Only - DentistPractitioner - Dentist 2264770619

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
060517NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Harold D Weiss DDS PC PastSince Dec 1, 2019 Accepting new patients

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1386137263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9323 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364806",
            "telephone_number": "718-763-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9323 AVENUE L",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112364806",
            "telephone_number": "718-763-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDHAWA",
        "first_name": "SANDEEP",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-14",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "060517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.