Elisa Sin, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

56422 Issued in CA

Practice address

41250 12TH St W Ste a
Palmdale, CA 93551-1444

Phone

(617) 620-0873

NPI assigned

Oct 4, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1659655090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41250 12TH ST W STE A",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511444",
            "telephone_number": "617-620-0873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41250 12TH ST W STE A",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935511444",
            "telephone_number": "617-620-0873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIN",
        "first_name": "ELISA",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE60249811",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "56422",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "D07398",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald S Simmons, B.D.S.
• Jasmine Joyce Simmons
• Sharie Simmons
• Aimee Simpson
• Jason Simpson
• Nikta Sinai, O.D.
• Jaspreet Singh, M.D.
• Lilia Siordia, LMFT
• Vincent P Sison
• Sivalingam Medical Corporation, Inc.

• Periodontics in Palmdale, CA
• Providers in Palmdale, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.