Nissa Siddiqi, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

110824 Issued in CA

Practice address

21001 San Ramon Valley Blvd Ste C6
San Ramon, CA 94583-3456

Phone

(925) 395-2786

NPI assigned

Jul 6, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Mokbil and Bautista Dental Corporation

  • General Practice Dentistry
  • San Ramon, CA
  • NPI 1033982830
  NPD
• Eva Bender Dental Corporation

  • General Practice Dentistry
  • Pleasant Hill, CA
  • NPI 1639465594
  NPD (past)
• Dental Care Center LTD

  • Dentist
  • Villa Park, IL
  • NPI 1952560674
  NPD (past)

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1821776212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6735 ELMCROFT CIR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402415846",
            "telephone_number": "502-873-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 SAN RAMON VALLEY BLVD STE C6",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945833456",
            "telephone_number": "925-395-2786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2380 Monument Blvd Ste F",
            "address_purpose": "LOCATION",
            "city": "Pleasant Hill",
            "state": "CA",
            "postal_code": "945233972",
            "country_code": "US",
            "telephone_number": "925-363-4455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIDDIQI",
        "first_name": "NISSA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-06",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "0198034383",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neha R Shrestha
• Shilpa Shrestha, FNP-C
• Vicky Siauw
• Suzanne Rose Sibilla, MA, LMFT
• Zeba Siddiq, DMD
• Reema Siddiqui, M.S, BCBA
• Kathryn A Sieben
• Sienie K Siefa
• Michelle Sieng
• Natalyia Sifuentes

• General Practice Dentistry in San Ramon, CA
• Providers in San Ramon, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 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.