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1285551945 NPI number — KHALSA KIDS LLC

NPI Number: 1285551945
Health Care Provider/Practitioner: KHALSA KIDS LLC

Information about “1285551945” NPI (KHALSA KIDS LLC) exists in 1285551945 in HTML format HTML  |  1285551945 in plain Text format TXT  |  1285551945 in PDF (Portable Document Format) PDF  |  1285551945 in an XML format XML  formats.

NPI Number : 1285551945 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1285551945",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "KHALSA KIDS LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "8103 E PALOMA AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MESA",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85212-9052",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "480-290-8428",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4100 S LINDSAY RD STE 106",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GILBERT",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85297-1507",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "480-963-4636",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/02/2026",
    "LastUpdateDate": "07/02/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GREWAL",
    "AuthorizedOfficialFirstName": "HAPPY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PEDIATRIC DENTIST",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DDS",
    "AuthorizedOfficialTelephoneNumber": "480-290-8428",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1223P0221X",
        "TaxonomyName": "Pediatric Dentistry",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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