Sidky Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12056 Issued in MN

Legal business name

SIDKY FAMILY DENTISTRY

Practice address

557 Prairie Center Dr
Eden Prairie, MN 55344-5379

Phone

(952) 405-8838

NPI assigned

Jan 23, 2009

Last updated

Jan 23, 2009By 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. Haydi Robeir Sidky, DDSNPI 1235203761

Title

Owner / Dentist

Phone

(952) 405-8838

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Haydi Robeir Sidky, D.D.S.

  • General Practice Dentistry
  • Eden Prairie, MN
  • NPI 1235203761
  NPD (past) Authorized official

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1811135288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 PRAIRIE CENTER DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445379",
            "telephone_number": "952-405-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 PRAIRIE CENTER DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445379",
            "telephone_number": "952-405-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIDKY FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-23",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "SIDKY",
        "authorized_official_first_name": "HAYDI",
        "authorized_official_middle_name": "ROBEIR",
        "authorized_official_title_or_position": "OWNER / DENTIST",
        "authorized_official_telephone_number": "952-405-8838",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12056",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "988179400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shiraz Asif DDS,LLC (Anderson Lake Dental)
• Leah Yvonne Shirley, CMT
• Evanthia Nicole Shook, DMD
• Thomas Chung Tong Hon Shum
• Andrew Terry Sideris, MD
• Haydi Robeir Sidky, D.D.S.
• Scott Douglas Sidney, MD
• Siham Healing Wellness Center LLC
• Casey Michelle Sikes, NP
• Rachel M Sikkink, LADC

• General Practice Dentistry in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; 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.