Individual provider Active NPI

Shirene Karen Siddiqui, DDS

  • Dentist
  • Houston, TX
National Provider Identifier
1821133216
Registry record updated Aug 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22269 Issued in TX
Practice address
1809 North Main
La Casa Nueva de Amigos
Houston, TX 77009
Phone
(713) 547-8076
Fax
(713) 547-8130
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22269 TX Primary

Addresses

Primary practice location

1809 North Main
La Casa Nueva de Amigos
Houston, TX 77009

Mailing address

PO Box 88361
City of Houston Health & Human Services
Houston, TX 77288-8861
Phone (713) 794-9104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22269TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344988800000",
    "number": "1821133216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88361",
            "address_2": "CITY OF HOUSTON HEALTH & HUMAN SERVICES",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772888861",
            "telephone_number": "713-794-9104",
            "fax_number": "713-798-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 NORTH MAIN",
            "address_2": "LA CASA NUEVA DE AMIGOS",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77009",
            "telephone_number": "713-547-8076",
            "fax_number": "713-547-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDDIQUI",
        "first_name": "SHIRENE",
        "middle_name": "KAREN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2012-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "22269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2012; 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.