Individual provider Active NPI

Kapil Grewal, DDS

  • Dentist
  • Albuquerque, NM
National Provider Identifier
1881003648
Registry record updated Apr 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DD4182 Issued in NM
Practice address
717 Encino PL NE
Ste 6
Albuquerque, NM 87102-2624
Phone
(505) 247-8005
Fax
(505) 843-8589
NPI assigned
Aug 6, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DD4182 NM Primary

Addresses

Primary practice location

717 Encino PL NE
Ste 6
Albuquerque, NM 87102-2624

Mailing address

717 Encino PL NE
Ste 6
Albuquerque, NM 87102-2624
Phone (505) 247-8005

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
DD4182NMMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459728000000",
    "number": "1881003648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 ENCINO PL NE",
            "address_2": "STE 6",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022624",
            "telephone_number": "505-247-8005",
            "fax_number": "505-843-8589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 ENCINO PL NE",
            "address_2": "STE 6",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022624",
            "telephone_number": "505-247-8005",
            "fax_number": "505-843-8589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREWAL",
        "first_name": "KAPIL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2016-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD4182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.