Jagdeep Dhall, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN23561 Issued in FL

Practice address

430 Waymont CT
Lake Mary, FL 32746-6745

Phone

(724) 840-5066

NPI assigned

Jul 6, 2018

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Jagdeep Dhall, D.M.D., P.a.

  • Dental Clinic/Center
  • Lake Mary, FL
  • NPI 1770100976
  NPD Authorized official
• Comfortable Care Dental Health Professionals, PA

  • General Practice Dentistry
  • Orange Park, FL
  • NPI 1679785315
  NPD (past)

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

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593734400000",
    "number": "1750877346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 WAYMONT CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466745",
            "telephone_number": "724-840-5066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 WAYMONT CT",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327466745",
            "telephone_number": "724-840-5066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALL",
        "first_name": "JAGDEEP",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-06",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN23561",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermacare Senior Solutions LLC
• Gabriella Yolanda Desantis
• Karen Desir, APRN
• Mercedes Despaigne
• Pamela Dewitt
• Azra Dhanji, NP
• Jorge Orlando Diaz, MD
• Marjorie Diaz, PT
• Rene Jairo Diaz
• Tehlah Dickson

• General Practice Dentistry in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; 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.