Individual provider Active NPI

Gurbaz Sandhu, DDS

  • Dentist
  • Dallas, TX
National Provider Identifier
1457720674
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
31420 Issued in TX
Practice address
10909 Webb Chapel Rd # 121
Dallas, TX 75229-3739
Phone
(408) 835-3726
NPI assigned
Sep 17, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 31420 TX Primary

Addresses

Primary practice location

10909 Webb Chapel Rd # 121
Dallas, TX 75229-3739

Mailing address

10909 Webb Chapel Rd # 121
Dallas, TX 75229-3739
Phone (408) 835-3726

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160929001945 MI Order and Referring Only - DentistPractitioner - Dentist 5597052837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31420TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1457720674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10909 WEBB CHAPEL RD # 121",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752293739",
            "telephone_number": "408-835-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10909 WEBB CHAPEL RD # 121",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752293739",
            "telephone_number": "408-835-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDHU",
        "first_name": "GURBAZ",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.