Individual provider Active NPI

Amrit P Kullar, D.M.D.

  • Dentist
  • Tracy, CA
National Provider Identifier
1982689998
Registry record updated Aug 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54356 Issued in CA
Practice address
4598 S Tracy Blvd
Suite 150
Tracy, CA 95377-8107
Phone
(209) 597-0381
NPI assigned
Dec 13, 2005
Last updated
Aug 16, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 54356 CA Primary

Addresses

Primary practice location

4598 S Tracy Blvd
Suite 150
Tracy, CA 95377-8107

Mailing address

71 S Pacifico St
Mountain House, CA 95391-2072
Phone (209) 597-0381

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376611200000",
    "number": "1982689998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 S PACIFICO ST",
            "city": "MOUNTAIN HOUSE",
            "state": "CA",
            "postal_code": "953912072",
            "telephone_number": "209-597-0381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4598 S TRACY BLVD",
            "address_2": "SUITE 150",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953778107",
            "telephone_number": "209-597-0381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLAR",
        "first_name": "AMRIT",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-13",
        "last_updated": "2013-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; 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.