Affan N Siddiqui, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

26062 Issued in FL

Practice address

23680 US 19 N
Clearwater, FL 33765-1571

Phone

(727) 799-1010

NPI assigned

Jul 6, 2021

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

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Coast Florida P.a.

  • Dentist
  • Clearwater, FL
  • NPI 1437725751
  NPD
• Coast Florida P.a.

  • Dentist
  • Tampa, FL
  • NPI 1730287673
  NPD (past)

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

{
    "created_epoch": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1639740269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CLEVELAND ST APT 701",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337554852",
            "telephone_number": "813-997-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23680 US 19 N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337651571",
            "telephone_number": "727-799-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "AFFAN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "26062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Shukla, PHARM.D
• Rebecca Jane Shytle, APRN
• Carissa J Sica, DPM
• Warren Siciliano, PHARMD
• Regina Sickles
• Anwar Siddiqui
• Nancy Ellen Sidrow, LMHC
• Clarisse Dewberry Siegel, PA-C
• Sight and Sun Eyeworks LLC
• Lisa M. Signorelli, LCSW

• General Practice Dentistry in Clearwater, FL
• Providers in Clearwater, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.