Individual provider Active NPI

Rupinder Kaur Chahal, DDS

  • Dentist
  • Modesto, CA
National Provider Identifier
1417094616
Registry record updated Feb 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
51599 Issued in CA
Practice address
1912 Standiford Ave, Suite 1
Modesto, CA 95350
Phone
(209) 522-6400
Fax
(209) 522-8761
NPI assigned
Jan 30, 2007
Last updated
Feb 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 51599 CA Primary
General Practice Dentistry 1223G0001X 51599 CA

Addresses

Primary practice location

1912 Standiford Ave, Suite 1
Modesto, CA 95350

Mailing address

1912 Standiford Ave, Suite 1
Modesto, CA 95350
Phone (209) 522-6400

Other identifiers 1

IdentifierTypeStateIssuer
D51599MedicaidCA

Other names 1

  • Dr. Rupinder Kaur Former name

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
I20160711000687 CA Order and Referring Only - DentistPractitioner - Dentist 7810289980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
51599CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1391731200000",
    "number": "1417094616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 STANDIFORD AVE, SUITE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-522-6400",
            "fax_number": "209-522-8761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 STANDIFORD AVE, SUITE 1",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "95350",
            "telephone_number": "209-522-6400",
            "fax_number": "209-522-8761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAHAL",
        "first_name": "RUPINDER",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "51599",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51599",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D51599",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RUPINDER",
            "last_name": "KAUR",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.