Ahmed Husain Siddiqi, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401417240 Issued in VA

Practice address

12100 Jefferson Ave
Newport News, VA 23602-6908

Phone

(732) 668-9275

NPI assigned

Jul 12, 2011

Last updated

Oct 13, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Southern Indian Health Council

  • Health Service Clinic/Center
  • Campo, CA
  • NPI 1922090885
  NPD (past)
• Summit Dental Center

  • General Practice Dentistry
  • Pasadena, TX
  • NPI 1194885558
  NPD (past)

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

{
    "created_epoch": "1310428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1154619120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12108 FOREST SAGE LN",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775844573",
            "telephone_number": "713-340-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12100 JEFFERSON AVE",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236026908",
            "telephone_number": "732-668-9275"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3631 Spencer Hwy",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "TX",
            "postal_code": "775041111",
            "country_code": "US",
            "telephone_number": "832-673-0999 x232",
            "fax_number": "281-657-2406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "AHMED",
        "middle_name": "HUSAIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-12",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "26557",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401417240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26557",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Jane Shuster, LCSW
• Robert Craig Shwayder, M.D.
• Ilona Sibirtsev, DDS
• Jacob Sicinski, PHARMD
• Soumya Sarang Sidana, DO
• Alissa Siemers, MSED, ATC, VATL
• Eneida Sierra, LPC, CCTP, NCC
• Charles Leeman Dennis Sifton, M.D.
• Signature Hope Cranial Crowns Consultant LLC
• Richard D Siira, MD

• General Practice Dentistry in Newport News, VA
• Providers in Newport News, 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 Oct 13, 2022; 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.