Organization Active NPI

Jasleen Brar DDS Inc

  • Dentist
  • Tustin, CA
National Provider Identifier
1790900199
Registry record updated Jun 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
43903 Issued in CA
Legal business name
JASLEEN BRAR DDS INC
Practice address
18102 Irvine Blvd
Ste 205
Tustin, CA 92780-3402
Phone
(714) 731-5656
Fax
(714) 731-2607
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2018

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

Authorized official

Name
Dr. Jasleen Brar, DDSNPI 1538233432
Title
President
Phone
(714) 731-5656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 43903 CA Primary

Addresses

Primary practice location

18102 Irvine Blvd
Ste 205
Tustin, CA 92780-3402

Mailing address

18102 Irvine Blvd
Ste 205
Tustin, CA 92780
Phone (714) 731-5656

Other names 1

  • A A Family Dental Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180808002360 CA Part B Supplier - Clinic/Group Practice 5395093215 Receives reassigned benefits from 2 practitioners
Practice locations: Tustin, CA

National Provider Directory

National Provider Directory

Locations

18102 Irvine Blvd
Ste 205
Tustin, CA 92780
Phone (714) 731-5656

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529625600000",
    "number": "1790900199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD",
            "address_2": "STE 205",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "714-731-5656",
            "fax_number": "714-731-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18102 IRVINE BLVD",
            "address_2": "STE 205",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927803402",
            "telephone_number": "714-731-5656",
            "fax_number": "714-731-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASLEEN BRAR DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2018-06-22",
        "status": "A",
        "authorized_official_last_name": "BRAR",
        "authorized_official_first_name": "JASLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-731-5656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "43903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A A Family Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A A Family Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.