Pritpal Johal, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DD22006 Issued in NM

Practice address

3211 Coors Blvd SW Ste D2
Albuquerque, NM 87121-5255

Phone

(209) 765-4246

NPI assigned

Jul 16, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1922584663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 DIAMOND MESA TRL SW APT 2703",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871213718",
            "telephone_number": "209-765-4246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3211 COORS BLVD SW STE D2",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871215255",
            "telephone_number": "209-765-4246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHAL",
        "first_name": "PRITPAL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6548",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NM",
            "license": "DD22006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Ahrend LCSW LLC
• Asa Joe
• Joel S. Saland, M.D., P.a.
• Gary Michael Joffe, MD
• Sarah Joh, MD
• Ellen Storm Johannsen, MS
• Garrett Johannsen, DDS
• Cheryl Lee Ann Johansen, LADAC
• Robert W. Johansen, D.D.S.
• Annika Johansson

• Dentist in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Dentist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; 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.