NPIMap

Organization Active NPI

Prabhjot Sidhu, PLLC

  • General Practice Dentistry
  • Issaquah, WA
National Provider Identifier
1477375350
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PRABHJOT SIDHU, PLLC
Practice address
5006 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-9220
Phone
(425) 391-7645
Fax
(425) 391-7699
NPI assigned
Oct 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Authorized official

Name
Prabhjot Sidhu, DDSNPI 1467646497
Title
Owner
Phone
(347) 453-2111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5006 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-9220

Mailing address

5006 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-9220
Phone (425) 391-7645

National Provider Directory

National Provider Directory

Locations

5006 E Lake Sammamish Pkwy SE
Issaquah, WA 98029
Phone (425) 391-7645

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1730246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730246400000",
    "number": "1477375350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5006 E LAKE SAMMAMISH PKWY SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980299220",
            "telephone_number": "425-391-7645",
            "fax_number": "425-391-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5006 E LAKE SAMMAMISH PKWY SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980299220",
            "telephone_number": "425-391-7645",
            "fax_number": "425-391-7699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRABHJOT SIDHU, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A",
        "authorized_official_last_name": "SIDHU",
        "authorized_official_first_name": "PRABHJOT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "347-453-2111",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.