Amandeep Kaur Brar, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DDS105397 Issued in CA

Practice address

1507 W Yosemite Ave
Manteca, CA 95337-5182

Phone

(209) 914-0659

NPI assigned

Aug 10, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Sidhu Brar Dental Group Inc

  • General Practice Dentistry
  • Mountain House, CA
  • NPI 1255270641
  NPD

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

{
    "created_epoch": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1710598271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 NORTHINGTON DR",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953778469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 W YOSEMITE AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953375182",
            "telephone_number": "209-914-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAR",
        "first_name": "AMANDEEP KAUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019032868",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS105397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda J Bouchard, M.D.
• Scott George Bourns, D.O.
• Samantha Bouth
• Coral Boyle-Day
• Zaniah Bradshaw
• Kanwarjeet Singh Brar, M.D.
• Jamie Bravo Salas
• Blanca A Bravo Valdovinos
• Rhonda M. Brazil, N.P.
• Lorraine Breen

• Dentist in Manteca, CA
• Providers in Manteca, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.

Verify at the official NPI Registry.