Individual provider Active NPI

Aneel Kaur Randhawa, D.D.S.

  • Dentist
  • Warren, MI
National Provider Identifier
1790841633
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019199 Issued in MI
Practice address
30801 Schoenherr Rd Ste 200
Warren, MI 48088-6863
Phone
(586) 558-8200
Fax
(586) 558-8300
NPI assigned
Dec 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901019199 MI Primary

Addresses

Primary practice location

30801 Schoenherr Rd Ste 200
Warren, MI 48088-6863

Mailing address

50481 Koss Dr
Macomb, MI 48044-6320
Phone (586) 226-0638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20150526001877 MI Order and Referring Only - DentistPractitioner - Dentist 1759601198

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901019199MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
A1 Family Dentistry of Flint,PLC Current Accepting new patients
A1 Family Dentistry of Clinton Township,PLC Current Accepting new patients
A1 Family Dentistry of Waterford,PLC Current Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1790841633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50481 KOSS DR",
            "city": "MACOMB",
            "state": "MI",
            "postal_code": "480446320",
            "telephone_number": "586-226-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30801 SCHOENHERR RD STE 200",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480886863",
            "telephone_number": "586-558-8200",
            "fax_number": "586-558-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDHAWA",
        "first_name": "ANEEL",
        "middle_name": "KAUR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

Verify at the official NPI Registry.