Roohan Sidhu, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

11479 Issued in CT

Practice address

240 Spencer St
Dr Dental
Manchester, CT 06040-4618

Phone

(860) 645-8000

NPI assigned

Aug 14, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1043686959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 WILLIAM PENN PLZ",
            "address_2": "APT 1003",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042545",
            "telephone_number": "904-514-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 SPENCER ST",
            "address_2": "DR DENTAL",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404618",
            "telephone_number": "860-645-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "ROOHAN",
        "name_prefix": "Miss",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-14",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "11479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Whitney Showman-Boyer, PA-C
• Lina Shroof, M.D.
• Frederick Shuler, MD
• Wen Priscella Si
• Sidet Sou, OD, LLC
• Karin L Sidman-Croghan, LPC
• Jahnna R Sieckowski
• Alexis Siegel, PA-C
• Diane Sieh
• David Sierra

• Dentist in Manchester, CT
• Providers in Manchester, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.