Active NPI
Zahir M Siddiqui
- General Practice Dentistry
- Janesville, WI
National Provider Identifier
1164034245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 1002409
- Practice address
- 1260 Milton Ave Ste 140
Janesville, WI 53545-1890 - Phone
- (888) 988-4066
- NPI assigned
- Aug 19, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 1002409 | WI | Primary |
Addresses
Primary practice location
1260 Milton Ave Ste 140
Janesville, WI 53545-1890
Mailing address
2050 E Algonquin Rd Ste 610
Schaumburg, IL 60173-4166
Phone (888) 988-4066
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1002409 | WI | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Familia Dental Janesville LLC | General Practice | Current | Accepting new patients |
Locations
2050 E Algonquin Rd
Ste 610
Schaumburg, IL 60173
Phone (847) 701-1457
1260 Milton Ave
Ste 140
Janesville, WI 53545
Phone (608) 757-0057
Organizations & group practices 1
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": "1597795200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597795200000",
"number": "1164034245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 E ALGONQUIN RD STE 610",
"city": "SCHAUMBURG",
"state": "IL",
"postal_code": "601734166",
"telephone_number": "888-988-4066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 MILTON AVE STE 140",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535451890",
"telephone_number": "888-988-4066"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDDIQUI",
"first_name": "ZAHIR",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-19",
"last_updated": "2020-08-19",
"certification_date": "2020-08-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WI",
"license": "1002409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Janesville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.