Individual provider Active NPI

Sundeep K Shergill, DDS

  • Dentist
  • Concord, CA
National Provider Identifier
1689870453
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
57161 Issued in CA
Practice address
4305 Clayton Rd
Suite G
Concord, CA 94521-2800
Phone
(925) 677-1100
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 57161 CA Primary

Addresses

Primary practice location

4305 Clayton Rd
Suite G
Concord, CA 94521-2800

Mailing address

4305 Clayton Rd
Suite G
Concord, CA 94521-2800
Phone (925) 677-1100

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

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1689870453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 CLAYTON RD",
            "address_2": "SUITE G",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945212800",
            "telephone_number": "925-677-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 CLAYTON RD",
            "address_2": "SUITE G",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945212800",
            "telephone_number": "925-677-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERGILL",
        "first_name": "SUNDEEP",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.