Healthcare Provider Details

I. General information

NPI: 1578804050
Provider Name (Legal Business Name): HARLEEN MANN-GREWAL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HARLEEN MANN DDS

II. Dates (important events)

Enumeration Date: 03/08/2013
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28532 LA MADRID DR STE B
SANTA CLARITA CA
91350-5864
US

IV. Provider business mailing address

28532 LA MADRID DR STE B
SANTA CLARITA CA
91350-5864
US

V. Phone/Fax

Practice location:
  • Phone: 661-244-4036
  • Fax: 661-347-5776
Mailing address:
  • Phone: 661-244-4036
  • Fax: 661-347-5776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS100849
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number100849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: