Individual provider Active NPI

Aprinderpal Singh Dhaliwal, DMD

  • General Practice Dentistry
  • Auburn, WA
National Provider Identifier
1801415286
Registry record updated Jun 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61073797 Issued in WA
Practice address
1030 Outlet Collection Way SW
Auburn, WA 98001-6537
Phone
(253) 333-9500
NPI assigned
Apr 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61073797 WA Primary

Addresses

Primary practice location

1030 Outlet Collection Way SW
Auburn, WA 98001-6537

Mailing address

4602 45TH Ave NE Apt 286
Tacoma, WA 98422-2097
Phone (206) 331-7177

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

State licenses

LicenseStateTypeSpecialty
61073797WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Dhaliwal DMD PLLC CurrentSince Apr 28, 2024 Accepting new patients
Singh Im PLLC PastSince Jun 28, 2020 Accepting new patients

Locations

5712 E Lake Sammamish Pkwy SE
Ste 108
Issaquah, WA 98029
Phone (425) 329-7262

Organizations & group practices 2

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": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592611200000",
    "number": "1801415286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4602 45TH AVE NE APT 286",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984222097",
            "telephone_number": "206-331-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 OUTLET COLLECTION WAY SW",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980016537",
            "telephone_number": "253-333-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "APRINDERPAL",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2020-06-20",
        "certification_date": "2020-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "61073797",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.