Individual provider Active NPI

Manpreetkaur Majorsingh Punjabi

  • General Practice Dentistry
  • Stockton, CA
National Provider Identifier
1508674540
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
111087 Issued in CA
Practice address
678 N Wilson Way
Stockton, CA 95205-4272
Phone
(209) 235-0226
NPI assigned
Dec 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 111087 CA Primary

Addresses

Primary practice location

678 N Wilson Way
Stockton, CA 95205-4272

Mailing address

206 Continente Ave
Brentwood, CA 94513-1969
Phone (209) 774-8080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111087CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1734912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1508674540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 CONTINENTE AVE",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945131969",
            "telephone_number": "209-774-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "678 N WILSON WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952054272",
            "telephone_number": "209-235-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUNJABI",
        "first_name": "MANPREETKAUR",
        "middle_name": "MAJORSINGH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "111087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 23, 2024; 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.