Active NPI
Ricky Brar, D.D.S.
- General Practice Dentistry
- Modesto, CA
National Provider Identifier
1639337660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 50213
- Practice address
- 1130 Coffee Rd
#1A
Modesto, CA 95355-4228 - Phone
- (209) 523-5991
- Fax
- (209) 523-5999
- NPI assigned
- May 27, 2008
- Last updated
- May 27, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | 50213 | CA | Primary |
Addresses
Primary practice location
1130 Coffee Rd
#1A
Modesto, CA 95355-4228
Mailing address
1130 Coffee Rd
#1A
Modesto, CA 95355-4228
Phone (209) 523-5991
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
| License | State | Type | Specialty |
|---|---|---|---|
| 50213 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| D Park DDS Inc | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211846400000",
"number": "1639337660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1130 COFFEE RD",
"address_2": "#1A",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554228",
"telephone_number": "209-523-5991",
"fax_number": "209-523-5999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 COFFEE RD",
"address_2": "#1A",
"city": "MODESTO",
"state": "CA",
"postal_code": "953554228",
"telephone_number": "209-523-5991",
"fax_number": "209-523-5999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAR",
"first_name": "RICKY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-27",
"last_updated": "2008-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "50213",
"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 May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.