Organization Active NPI

Pooja Goel, DDS and Gurpreet Kaur, RDH, a Professional Dental Corp.

  • Dentist
  • Santa Clara, CA
National Provider Identifier
1407281850
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50603 Issued in CA
Legal business name
POOJA GOEL, DDS AND GURPREET KAUR, RDH, A PROFESSIONAL DENTAL CORP.
Practice address
310 N Winchester Blvd
Santa Clara, CA 95050-6502
Phone
(408) 205-1106
NPI assigned
Sep 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Authorized official

Name
Gurpreet Kaur
Title
Vice-President
Phone
(408) 205-1106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 50603 CA Primary

Addresses

Primary practice location

310 N Winchester Blvd
Santa Clara, CA 95050-6502

Mailing address

310 N Winchester Blvd
Santa Clara, CA 95050-6502
Phone (408) 205-1106

Other names 1

  • Smiles For Life Dental Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151120002400 CA DME Supplier - Oral Surgery - Dentist 5092015198 Practice locations: Santa Clara, CA

National Provider Directory

National Provider Directory

Locations

1569 Lexann Ave
Ste 228
San Jose, CA 95121

310 N Winchester Blvd
Santa Clara, CA 95050
Phone (408) 205-1106

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1378252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1407281850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N WINCHESTER BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506502",
            "telephone_number": "408-205-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N WINCHESTER BLVD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506502",
            "telephone_number": "408-205-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POOJA GOEL, DDS AND GURPREET KAUR, RDH, A PROFESSIONAL DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-04",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "KAUR",
        "authorized_official_first_name": "GURPREET",
        "authorized_official_title_or_position": "VICE-PRESIDENT",
        "authorized_official_telephone_number": "408-205-1106"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "50603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles For Life Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Clara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.