T Sidal DDS MD Inc

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

A122601 Issued in CA

Legal business name

T SIDAL DDS MD INC

Practice address

12395 El Camino Real, Suite 304
Torrey Pines Oral & Maxillofacial Surgery
San Diego, CA 92130

Phone

(858) 793-3393

NPI assigned

Jun 25, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Tarkan Sidal, DDS,MD

Title

President

Phone

(312) 505-8656

Specialties & licenses 2

Addresses

Other names 1

• TORREY PINES ORAL AND MAXILLOFACIAL SURGERY Doing business as

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1659753762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL, SUITE 304",
            "address_2": "TORREY PINES ORAL & MAXILLOFACIAL SURGERY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92130",
            "telephone_number": "858-793-3393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12395 EL CAMINO REAL, SUITE 304",
            "address_2": "TORREY PINES ORAL & MAXILLOFACIAL SURGERY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92130",
            "telephone_number": "858-793-3393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T SIDAL DDS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-25",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "SIDAL",
        "authorized_official_first_name": "TARKAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-505-8656",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS,MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS 101",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "A122601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TORREY PINES ORAL AND MAXILLOFACIAL SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• George P. Szollar, MD
• Jacklynn Sztain, MD
• Yun Yu Szu
• Andrea Szulik
• Jennifer Szutu, PA-C
• T3 Managment
• Amanda Ta
• Canhnghi Ta
• Hien Thi Ta, RPH
• Jennifer Ta

• Oral & Maxillofacial Surgery (D.M.D.) in San Diego, CA
• Providers in San Diego, CA by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.