Individual provider Active NPI

Hardeep K Sidhu, DDS

  • Dentist
  • Roseville, CA
National Provider Identifier
1558593277
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58646 Issued in CA
Practice address
3783 Westchester Dr
Roseville, CA 95747-6354
Phone
(916) 420-5746
NPI assigned
Aug 13, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 58646 CA Primary

Addresses

Primary practice location

3783 Westchester Dr
Roseville, CA 95747-6354

Mailing address

3783 Westchester Dr
Roseville, CA 95747-6354
Phone (916) 420-5746

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151028000436 CA Order and Referring Only - DentistPractitioner - Dentist 4789993064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
58646CAMDDentist

Interoperability endpoints

  • Direct secure messaging: hsidhu@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1558593277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3783 WESTCHESTER DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957476354",
            "telephone_number": "916-420-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3783 WESTCHESTER DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957476354",
            "telephone_number": "916-420-5746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDHU",
        "first_name": "HARDEEP",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-13",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.