Manpreet Gosal Grewal, DDS

Key facts

NPI

1811027261

Entity type

Individual (NPI type 1)

Primary specialty

Dentist 122300000X

License

45866 (CA)

Practice address

5460 Orange Avenue
Cypress, CA 90630-3740

Phone

(714) 226-9630

Fax

(714) 226-0190

NPI assigned

Mar 6, 2007

Sex

Female

Sole proprietor

No

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.

• Cypress Plaza Dental Group Dental Clinic/Center · Cypress, CA · NPI 1356923072
  NPD Authorized official
• Manpreet G Grewal DDS Inc General Practice Dentistry · Cypress, CA · NPI 1881320851
  NPD Authorized official

Medicare participation

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

Practice roles

Locations

Specialties & licenses

Addresses

Other names

• Manpreet Gosal Former name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 7, 2022.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1811027261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5440 CASTLE BEND WAY",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928874254",
            "telephone_number": "714-226-9630",
            "fax_number": "714-226-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 ORANGE AVENUE",
            "city": "CYPRESS",
            "state": "CA",
            "postal_code": "906303740",
            "telephone_number": "714-226-9630",
            "fax_number": "714-226-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "MANPREET",
        "middle_name": "GOSAL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "45866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MANPREET",
            "last_name": "GOSAL",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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All providers in Cypress, CA · Dentist in California