Active NPI
Varinder Pannu
- General Practice Dentistry
- Modesto, CA
National Provider Identifier
1598127052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 100106
- Practice address
- 1720 E Hatch Rd
Modesto, CA 95351-5075 - Phone
- (209) 241-5905
- NPI assigned
- Mar 24, 2016
- Last updated
- Mar 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 100106 | CA | Primary |
Addresses
Primary practice location
1720 E Hatch Rd
Modesto, CA 95351-5075
Mailing address
23731 126TH PL SE
Kent, WA 98031-3731
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250703002700 | CA | Order and Referring Only - Dentist | 1951815752 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458777600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458777600000",
"number": "1598127052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23731 126TH PL SE",
"city": "KENT",
"state": "WA",
"postal_code": "980313731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 E HATCH RD",
"city": "MODESTO",
"state": "CA",
"postal_code": "953515075",
"telephone_number": "209-241-5905"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANNU",
"first_name": "VARINDER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-24",
"last_updated": "2016-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "100106",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.