Individual provider Active NPI

Jaspreet Kaur

  • Dentist
  • Santa Monica, CA
National Provider Identifier
1588859375
Registry record updated Feb 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
56050 Issued in CA
Practice address
2509 Pico Blvd
Santa Monica, CA 90405-1828
Phone
(310) 664-7878
NPI assigned
Sep 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 56050 CA Primary

Addresses

Primary practice location

2509 Pico Blvd
Santa Monica, CA 90405-1828

Mailing address

1023 Wilson PL
Santa Monica, CA 90405-5730
Phone (310) 663-4356

Other practice location 1

1023 Wilson Pl
Santa Monica, CA 90405-5730
Phone (310) 663-4356

Other identifiers 1

IdentifierTypeStateIssuer
D56050MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Jaspreet.kaur.p1@direct.venicefamilyclinic.nextgenshare.com Health Information Exchange (HIE)

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
I20240429001880 CA Practitioner - Dentist 5496195109 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56050CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic CurrentSince Mar 16, 2024 Accepting new patients
Venice Family Clinic Current Accepting new patients
Venice Family Clinic CurrentSince Mar 16, 2024 Accepting new patients
Venice Family Clinic Current Accepting new patients

Locations

4700 Inglewood Blvd
Ste 102
Los Angeles, CA 90230
Phone (310) 664-7901

2509 Pico Blvd
Santa Monica, CA 90405
Phone (310) 664-7901

604 Rose Ave
Venice, CA 90291
Phone (310) 392-8630

905 Venice Blvd
Venice, CA 90291
Phone (310) 392-8630

Interoperability endpoints

  • Direct secure messaging: jaspreet.kaur.p1@direct.venicefamilyclinic.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jkaur753501@direct.ochin.org

Organizations & group practices 5

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1588859375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 WILSON PL",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904055730",
            "telephone_number": "310-663-4356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2509 PICO BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904051828",
            "telephone_number": "310-664-7878"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1023 Wilson Pl",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904055730",
            "country_code": "US",
            "telephone_number": "310-663-4356",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "JASPREET",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-13",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56050",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D56050",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Jaspreet.kaur.p1@direct.venicefamilyclinic.nextgenshare.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2509 Pico Blvd",
            "city": "Santa Monica",
            "state": "CA",
            "country_code": "US",
            "postal_code": "904051828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.