NPIMap

Organization Active NPI

Gurjot Sidhu DDS Dental Corporation

  • Dentist
  • Stockton, CA
National Provider Identifier
1467053660
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
GURJOT SIDHU DDS DENTAL CORPORATION
Practice address
2701 E Hammer LN Ste 101
Stockton, CA 95210-4245
Phone
(209) 502-7770
NPI assigned
Nov 4, 2020
Organization subpart
Yes
Parent organization
GURJOT SIDHU DDS DENTAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Authorized official

Name
Gurjot Kaur SidhuNPI 1760857189
Title
President
Phone
(209) 502-7770

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

2701 E Hammer LN Ste 101
Stockton, CA 95210-4245

Mailing address

2701 E Hammer LN Ste 101
Stockton, CA 95210-4245
Phone (209) 502-7770

Other names 1

  • Summit Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gurjot Sidhu DDS Dental Corporation3 organizations share this tax ID, including this one
Part of
Gurjot Sidhu DDS Dental Corporation

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2701 E Hammer Ln
Ste 101
Stockton, CA 95210
Phone (209) 502-7770

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1604448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604448000000",
    "number": "1467053660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 E HAMMER LN STE 101",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952104245",
            "telephone_number": "209-502-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 E HAMMER LN STE 101",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952104245",
            "telephone_number": "209-502-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURJOT SIDHU DDS DENTAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GURJOT SIDHU DDS DENTAL CORPORATION",
        "enumeration_date": "2020-11-04",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A",
        "authorized_official_last_name": "SIDHU",
        "authorized_official_first_name": "GURJOT",
        "authorized_official_middle_name": "KAUR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-502-7770"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.