Anthony John Sidor, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 13170 Issued in FL

Practice address

225 S Plumosa St
Merritt Island, FL 32952-3525

Phone

(321) 453-1890

Fax

(321) 453-1521

NPI assigned

Jun 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Anthony J. Sidor, D.D.S., P.a.

  dba Merritt Island Smiles

  • Dentist
  • Merritt Island, FL
  • NPI 1114325776
  NPD (past) Authorized official

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418601600000",
    "number": "1740225036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 S PLUMOSA ST",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523525",
            "telephone_number": "321-453-1890",
            "fax_number": "321-453-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 S PLUMOSA ST",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329523525",
            "telephone_number": "321-453-1890",
            "fax_number": "321-453-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOR",
        "first_name": "ANTHONY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2014-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 13170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William E Shaw Jr., M.D.
• Steven Eugene Shepard, PT
• Tereasa Dianne Shepherd, P.T., MSHA
• Shrew Inc.
• Priscila Rosal Siaga Jenkins, RN
• Sigfredo Acosta Perez M.D. P.a. (Merritt Island Pediatrics)
• David Paul Sims, MD
• Jennifer April Sims, RMHCI
• Mary Lee Sims, CUSTOM FITTER
• Vanesha Singletary, RBT

• General Practice Dentistry in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2014; 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.