Edirin Elaine Sido, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

106959 Issued in CA

Practice address

4135 Blackhawk Plaza Cir Ste 260
Danville, CA 94506-4655

Phone

(925) 837-7745

NPI assigned

Apr 23, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

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

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1831753177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2357",
            "city": "DUBLIN",
            "state": "CA",
            "postal_code": "945680235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 BLACKHAWK PLAZA CIR STE 260",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945064655",
            "telephone_number": "925-837-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDO",
        "first_name": "EDIRIN",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11121",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NM",
            "license": "DB-2023-0058",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OR",
            "license": "D11121",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "106959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward N Shradar, RN
• William Jon Shryer, MSW, LCSW, DCSW
• Stacy Ann Shulenberger, D.C., C.C.E.P.
• Delia Belen Sidhu
• Manraj Sidhu
• Cynthia Villar Silorio, RN, NP
• Lawrence M. Silverman, M.D.
• Alexander Julian Simion
• Jamilla Simmons
• Lakshdeep Singh

• Pediatric Dentistry in Danville, CA
• Providers in Danville, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.