Ira Lee Sidwell, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS3767 Issued in TN

Practice address

1195 Old Hickory Blvd
Ste. 205
Brentwood, TN 37027-4239

Phone

(615) 269-5223

Fax

(615) 269-6384

NPI assigned

Jan 17, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1114907201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1195 OLD HICKORY BLVD",
            "address_2": "STE. 205",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274239",
            "telephone_number": "615-269-5223",
            "fax_number": "615-269-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 OLD HICKORY BLVD",
            "address_2": "STE. 205",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274239",
            "telephone_number": "615-269-5223",
            "fax_number": "615-269-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDWELL",
        "first_name": "IRA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS3767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Shoup, CNIM
• Shandle Lynn Shrable, NP
• Kelly A Shultz, D.C.
• Sherry Siarezi, M.D.
• Sidd Family Psychiatric PLLC
• Elizabeth Siegert, M.S, SLP
• Charles Andrew Sigmon, CNIM
• Lisa Robin Silver, LCSW
• Sean W. Silvernagel, M.D.
• Heather Silvers

• General Practice Dentistry in Brentwood, TN
• Providers in Brentwood, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.