Healthcare Provider Details

I. General information

NPI: 1396206066
Provider Name (Legal Business Name): HARLEEN GREWAL DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
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:
Mailing address:
  • Phone: 661-244-4036
  • Fax: 661-347-5776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: HARLEEN GREWAL
Title or Position: DIRECTOR
Credential: DDS
Phone: 213-804-5535