Indra Sidhu DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11295 Issued in MD

Legal business name

INDRA SIDHU DDS

Practice address

208 Crain Hwy S
Glen Burnie, MD 21061-3530

Phone

(410) 553-0651

Fax

(410) 510-1009

NPI assigned

Nov 11, 2010

Last updated

Jan 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Indra Sidhu, DDSNPI 1902056807

Title

Owner

Phone

(301) 498-0002

Specialties & licenses 1

Addresses

Tax ID family

Indra Sidhu DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Indra Sidhu DDS

  • Dental Clinic/Center
  • Glen Burnie, MD
  • NPI 1053953372
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Indra Sidhu, DDS

  • General Practice Dentistry
  • Laurel, MD
  • NPI 1902056807
  NPD Authorized official
• Munsha Sidhu Chadha, DMD

  • General Practice Dentistry
  • Brandon, FL
  • NPI 1487148631
  NPD

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

{
    "created_epoch": "1289433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705622400000",
    "number": "1699076307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 CRAIN HWY S",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613530",
            "telephone_number": "410-553-0651",
            "fax_number": "410-510-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 CRAIN HWY S",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613530",
            "telephone_number": "410-553-0651",
            "fax_number": "410-510-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDRA SIDHU DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-11",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A",
        "authorized_official_last_name": "SIDHU",
        "authorized_official_first_name": "INDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-498-0002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian Adaeze Imo, DNP, CRNP-PMH
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• Indra Sidhu DDS
• Infinite Vision, Inc. (Pearle Vision)
• Destiny Amy Ingram, APRN, FNP-C
• Inner Harbor Anesthesia, LLC
• Innovative Healthcare Training, Inc. (Next Level Recovery)
• Innovative Healthcare Training, Inc. (Next Level Mental Health Services)

• General Practice Dentistry in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.