Individual provider Active NPI

Harsheen Sidhu, DDS

  • Pediatric Dentistry
  • Corona, CA
National Provider Identifier
1063874709
Registry record updated Jul 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
104052 Issued in CA
Practice address
131 W Ontario Ave Ste 102
Corona, CA 92882-5274
Phone
(951) 898-9700
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 104052 CA Primary

Addresses

Primary practice location

131 W Ontario Ave Ste 102
Corona, CA 92882-5274

Mailing address

5037 Lipizzan Place
Rancho Cucamonga, CA 91737
Phone (909) 614-3552

Other practice location 1

923 N Milpas Street
Santa Barbara, CA 93103
Phone (805) 884-1998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
104052CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara Neighborhood Clinics Past Accepting new patients
CF Rodgers DDS Inc Multi-Specialty PastSince Jul 28, 2019 Accepting new patients
Santa Barbara Neighborhood Clinics Past Accepting new patients
Charles F Rodgers Dental Corporation PastSince Jul 28, 2019 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564012800000",
    "number": "1063874709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5037 LIPIZZAN PLACE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "91737",
            "telephone_number": "909-614-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W ONTARIO AVE STE 102",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928825274",
            "telephone_number": "951-898-9700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "923 N Milpas Street",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "93103",
            "country_code": "US",
            "telephone_number": "805-884-1998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "HARSHEEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2019-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "104052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.