Siddhant Gaidhane, GENERAL DENTIST

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401417096 Issued in VA

Practice address

2040 Coliseum Dr Ste A27
Hampton, VA 23666-3200

Phone

(757) 262-0020

NPI assigned

Jul 28, 2020

Sex

Male

Sole proprietor

Yes

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 PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EABGBA

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.

• Sadler Health Center Corporation

  • Federally Qualified Health Center (FQHC)
  • Carlisle, PA
  • NPI 1467494823
  Medicare reassignment NPD
• Sadler Health Center Corporation

  • Federally Qualified Health Center (FQHC)
  • Mechanicsburg, PA
  • NPI 1619681616
  NPD
• Family Dental of Virginia, LLC

  • General Practice Dentistry
  • Hampton, VA
  • NPI 1689942377
  NPD (past)
• Sadler Health Center Corporation

  • Federally Qualified Health Center (FQHC)
  • Loysville, PA
  • NPI 1740414416
  NPD (past)

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1093324840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 SHOCKOE LN APT 103",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232194084",
            "telephone_number": "804-269-2710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 COLISEUM DR STE A27",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236663200",
            "telephone_number": "757-262-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAIDHANE",
        "first_name": "SIDDHANT",
        "name_prefix": "Dr.",
        "credential": "GENERAL DENTIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea G Furlong, PA-C
• Edward Daniel Futch, LICENSED OPTICIAN
• Mary-Katherine Fuzy
• Oshan Darius Gadsden, PHD
• Tiana Marie Gagne, NP
• Samuel Edward Gainor, D.C.
• Katharine Lee Gallagher, BCABA
• Anacleto Gamit Gallanosa, MD
• Ceceil Christine Gallop, DDS
• Terrah Lenise Galloway

• General Practice Dentistry in Hampton, VA
• Providers in Hampton, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.