1861621641 NPI number — AMAN K GREWAL D.D.S.,M.D.S.,B.D.S.

NPI Number: 1861621641
Health Care Provider/Practitioner: AMAN K GREWAL D.D.S.,M.D.S.,B.D.S.

NPI Number : 1861621641 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861621641",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GREWAL",
    "FirstName": "AMAN",
    "MiddleName": "K",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "D.D.S.,M.D.S.,B.D.S.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FLYNN",
    "OtherFirstName": "AMAN",
    "OtherMiddleName": "K",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": "D.D.S.,M.D.S.,B.D.S.",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "637 HICKORY ST NW STE 110",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALBANY",
    "MailingAddressStateName": "OR",
    "MailingAddressPostalCode": "97321-1761",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "541-406-3500",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "637 HICKORY ST NW STE 110",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALBANY",
    "PracticeLocationAddressStateName": "OR",
    "PracticeLocationAddressPostalCode": "97321-1761",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "541-406-3500",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/14/2009",
    "LastUpdateDate": "05/14/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "019028052",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "D10809",
          "LicenseNumberStateCode": "OR",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "DEN-10325",
          "LicenseNumberStateCode": "CO",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}