P.Penny Siriwat, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

32994 Issued in CA

Practice address

515 S Beach Blvd
Suite C
Anaheim, CA 92804-1812

Phone

(714) 527-9006

Fax

(714) 527-5681

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1730266974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 S BEACH BLVD",
            "address_2": "SUITE C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041812",
            "telephone_number": "714-527-9006",
            "fax_number": "714-527-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S BEACH BLVD",
            "address_2": "SUITE C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928041812",
            "telephone_number": "714-527-9006",
            "fax_number": "714-527-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIRIWAT",
        "first_name": "P.PENNY",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "32994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B32994-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA CHILDREN SERVI",
            "identifier": "CGP#169380",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "32994",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B32994-02",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Soucheat Siou, MD
• Manuel Eduardo Sipowicz, MD
• Maria C. Sipowicz, MD
• Mason Sipple
• Aphisara Sirirungvikrai
• Emilio Medina Sison Jr., DDS
• Monique Sison, DDS
• Sisters Hospice Care
• Steve Sitar, M.D
• Mitchell Siy, DNP

• Orthodontics and Dentofacial Orthopedics Dentistry in Anaheim, CA
• Providers in Anaheim, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.