Individual provider Active NPI

Sabrina Kaur Dhanjal, DDS

  • Dentist
  • Avondale, AZ
National Provider Identifier
1487796751
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6987 Issued in AZ
Practice address
1430 N Central Ave
Ste a
Avondale, AZ 85323
Phone
(623) 932-0539
Fax
(623) 932-5494
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6987 AZ Primary

Addresses

Primary practice location

1430 N Central Ave
Ste a
Avondale, AZ 85323

Mailing address

1430 N Central Ave
Ste a
Avondale, AZ 85323
Phone (623) 932-0539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20150603001326 AZ Order and Referring Only - DentistPractitioner - Oral SurgeryPractitioner - Dentist 3072834027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6987AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Goodyear Dental LLC Current Accepting new patients

Locations

7025 N 75th Ave
Ste 101
Glendale, AZ 85303
Phone (480) 205-6961

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1487796751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 N CENTRAL AVE",
            "address_2": "STE A",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "85323",
            "telephone_number": "623-932-0539",
            "fax_number": "623-932-5494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 N CENTRAL AVE",
            "address_2": "STE A",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "85323",
            "telephone_number": "623-932-0539",
            "fax_number": "623-932-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHANJAL",
        "first_name": "SABRINA",
        "middle_name": "KAUR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "6987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avondale, AZ

Sources for this page

Verify at the official NPI Registry.