Organization Active NPI

Daljeet Singh Sidhu Dentist P.C.

  • Dentist
  • Astoria, NY
National Provider Identifier
1073503496
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
038097 Issued in NY
Legal business name
DALJEET SINGH SIDHU DENTIST P.C.
Practice address
4209 Broadway
Astoria, NY 11103-2700
Phone
(718) 204-9345
Fax
(718) 204-2467
NPI assigned
Oct 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Daljeet Singh Sidhu, DDSNPI 1831245141
Title
Dentist
Phone
(718) 204-9345

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 038097 NY Primary

Addresses

Primary practice location

4209 Broadway
Astoria, NY 11103-2700

Mailing address

4209 Broadway
Astoria, NY 11103-2700
Phone (718) 204-9345

Other identifiers 1

IdentifierTypeStateIssuer
00915540MedicaidNY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073503496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 BROADWAY",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111032700",
            "telephone_number": "718-204-9345",
            "fax_number": "718-204-2467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4209 BROADWAY",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111032700",
            "telephone_number": "718-204-9345",
            "fax_number": "718-204-2467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALJEET SINGH SIDHU DENTIST P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIDHU",
        "authorized_official_first_name": "DALJEET",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "718-204-9345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "038097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00915540",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Astoria, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.