Individual provider Active NPI

Navroop Dhillon, DDS

  • General Practice Dentistry
  • Rohnert Park, CA
National Provider Identifier
1396473682
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
107753 Issued in CA
Practice address
1625 Kassidy PL
Rohnert Park, CA 94928-5041
Phone
(530) 488-0556
NPI assigned
Aug 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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 107753 CA Primary

Addresses

Primary practice location

1625 Kassidy PL
Rohnert Park, CA 94928-5041

Mailing address

1625 Kassidy PL
Rohnert Park, CA 94928-5041
Phone (530) 488-0556

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
I20230120000683 CA Order and Referring Only - DentistPractitioner - Dentist 5193196616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107753CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1660262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1396473682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 KASSIDY PL",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949285041",
            "telephone_number": "530-488-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 KASSIDY PL",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949285041",
            "telephone_number": "530-488-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHILLON",
        "first_name": "NAVROOP",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

Verify at the official NPI Registry.