Shoaib Siddiqui, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D15370 Issued in MN

Practice address

1405 Anne St NW
Bemidji, MN 56601-5113

Phone

(218) 444-9646

Fax

(218) 444-9252

NPI assigned

Aug 13, 2025

Sex

Male

Sole proprietor

No

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": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1558247676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015113",
            "telephone_number": "218-308-7822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 ANNE ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015113",
            "telephone_number": "218-444-9646",
            "fax_number": "218-444-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SHOAIB",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D15370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olumayowa Beatrice Sholola, MD
• Jayten Shook, D.O.; MS
• Shoptikal LLC
• Donna Marie Shorter, PA-C
• Paula Shouse
• Kelly Siems, R.N.
• Lynda R Siepker, AUD
• Jamie Sindelar, DO
• Joginder Singh, MD
• David Bruce Sjostrom, B.A., LADC

• General Practice Dentistry in Bemidji, MN
• Providers in Bemidji, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; 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.