Sundeep Chahal Johal, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI021313 Issued in NJ

Practice address

239 Avenel St
Suite 7
Avenel, NJ 07001-1400

Phone

(732) 634-5600

Fax

(732) 634-5692

NPI assigned

Aug 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Johal Medical Enterprises

  dba avenel dental

  • Dental Clinic/Center
  • Colonia, NJ
  • NPI 1801808845
  NPD (past) Authorized official

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831100817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PARSON PL",
            "city": "COLONIA",
            "state": "NJ",
            "postal_code": "070672704",
            "telephone_number": "732-340-9018",
            "fax_number": "732-634-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 AVENEL ST",
            "address_2": "SUITE 7",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011400",
            "telephone_number": "732-634-5600",
            "fax_number": "732-634-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHAL",
        "first_name": "SUNDEEP",
        "middle_name": "CHAHAL",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI021313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0021547",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innovative Pain Care Center PC
• Ghosia Iqbal
• Divya Jain
• Patricia Jenkins
• Jersey Shore Psychiatric Services LLC
• John D Wilgucki DO LLC
• Amy E Johnson, LCSW
• Kerri-Ann Alisa Johnson
• Nicole Johnson, M.A., CCC-SLP
• Olivia Joseph

• General Practice Dentistry in Avenel, NJ
• Providers in Avenel, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.