MEDICARE: KHALSA KIDS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1285551945
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KHALSA KIDS LLC

Provider Business Mailing Address
First Line	:	8103 E PALOMA AVE
Second Line	:
City	:	MESA
State	:	AZ
Zip	:	85212-9052
Country	:	US
Telephone Number	:	480-290-8428
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 S LINDSAY RD STE 106
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85297-1507
Country	:	US
Telephone Number	:	480-963-4636
Fax Number	:

Authorized Official
Title or Position	:	PEDIATRIC DENTIST
Name	:	DR. HAPPY GREWAL
Credential	:	DDS
Telephone Number	:	480-290-8428

Provider Enumeration Date	:	07/02/2026
Last Update Date	:	07/02/2026

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Directions to “KHALSA KIDS LLC ” Practice Location

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