Anna Sidor, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

0401414281 Issued in VA

Practice address

7617 Little River Tpke Ste 910
Annandale, VA 22003-2618

Phone

(703) 462-9092

NPI assigned

Jul 13, 2010

Last updated

Oct 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Focus Dental Specialists

  dba Prestige Dental Specialists

  • Periodontics
  • Annandale, VA
  • NPI 1174118723
  NPD

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634256000000",
    "number": "1437461951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7617 LITTLE RIVER TPKE STE 910",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032618",
            "telephone_number": "703-462-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7617 LITTLE RIVER TPKE STE 910",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220032618",
            "telephone_number": "703-462-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOR",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2021-10-15",
        "certification_date": "2021-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401414281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@prestigedentalspecialists.com",
            "affiliation": "N",
            "address_1": "7617 Little River Tpke Ste 910",
            "city": "Annandale",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220032618",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@prestigedentalspecialists.com",
            "affiliation": "N",
            "address_1": "7617 Little River Tpke Ste 910",
            "city": "Annandale",
            "state": "VA",
            "country_code": "US",
            "postal_code": "220032618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Dentist in Annandale, VA
• Providers in Annandale, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2021; 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.