NPIMap

Organization Active NPI

Gurjot Sidhu DDS Dental Corporation

  • General Practice Dentistry
  • Riverbank, CA
National Provider Identifier
1851742696
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62962 Issued in CA
Legal business name
GURJOT SIDHU DDS DENTAL CORPORATION
Practice address
2119 Patterson Rd
Suite 9
Riverbank, CA 95367-9639
Phone
(209) 315-5299
NPI assigned
Jun 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Authorized official

Name
Dr. Gurjot Sidhu, DDSNPI 1760857189
Title
President
Phone
(650) 966-4844

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 62962 CA Primary

Addresses

Primary practice location

2119 Patterson Rd
Suite 9
Riverbank, CA 95367-9639

Mailing address

2119 Patterson Rd
Suite 9
Riverbank, CA 95367-9639

Other names 1

  • Riverbank Smiles Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gurjot Sidhu DDS Dental Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

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": "1466553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1851742696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2119 PATTERSON RD",
            "address_2": "SUITE 9",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953679639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2119 PATTERSON RD",
            "address_2": "SUITE 9",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953679639",
            "telephone_number": "209-315-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURJOT SIDHU DDS DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-22",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "SIDHU",
        "authorized_official_first_name": "GURJOT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-966-4844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverbank Smiles Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.