Mohammad T Siddiqui, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901602365 Issued in MI

Practice address

23800 Orchard Lake Rd Ste 106
Farmington Hills, MI 48336-2561

Phone

(248) 755-5700

NPI assigned

Jun 27, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1679259246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3654 WILTSHIRE",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481882956",
            "telephone_number": "734-262-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23800 ORCHARD LAKE RD STE 106",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362561",
            "telephone_number": "248-755-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "MOHAMMAD",
        "middle_name": "T",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Sicairos
• Samantha Sicairos
• Prakruthi Siddalinge Gowda
• Muslimah Siddiq
• Naimah Siddiq
• Alexis Nicole Siders
• Glenette Sides
• Krystal Sides
• Kylie Sides
• Terry Sides

• General Practice Dentistry in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; 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.