Individual provider Active NPI

Pardeep Singh Brar, D.D.S

  • General Practice Dentistry
  • Pasadena, CA
National Provider Identifier
1942493572
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D52043 Issued in CA
Practice address
1730 E Walnut St
Pasadena, CA 91106-1612
Phone
(626) 449-4795
Fax
(626) 449-7242
NPI assigned
Aug 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D52043 CA Primary

Addresses

Primary practice location

1730 E Walnut St
Pasadena, CA 91106-1612

Mailing address

1730 E Walnut St
Pasadena, CA 91106-1612
Phone (626) 449-4795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20160519002326 CA Order and Referring Only - DentistPractitioner - Dentist 1153610779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D52043CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Brar Family Dental Office Inc. CurrentSince Dec 6, 2020 Accepting new patients
Lawrence Villarreal DDS Inc PastSince Dec 6, 2020 Accepting new patients
Kaleka and Brar, a General Partnership General Practice Past Accepting new patients

Locations

1730 E Walnut St
Pasadena, CA 91106
Phone (626) 449-4795

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1942493572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 E WALNUT ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061612",
            "telephone_number": "626-449-4795",
            "fax_number": "626-449-7242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 E WALNUT ST",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911061612",
            "telephone_number": "626-449-4795",
            "fax_number": "626-449-7242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAR",
        "first_name": "PARDEEP",
        "middle_name": "SINGH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-27",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D52043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

Verify at the official NPI Registry.