=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689580508
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRAR DENTAL GROUP INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/20/2026
-----------------------------------------------------
Last Update Date | 08/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3300 CAMERON PARK DR
-----------------------------------------------------
City | CAMERON PARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95682-7914
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-672-2121
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1871 PETITE SYRAH LN
-----------------------------------------------------
City | ROSEVILLE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95747-6684
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. PRATEEK S BRAR
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 209-617-4193
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------