Active NPI
Jasjot Sidhu, DDS
- Dentist
- Manteca, CA
National Provider Identifier
1881345841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 106605
- Practice address
- 132 N Grant Ave
Manteca, CA 95336-4601 - Phone
- (209) 239-5996
- NPI assigned
- Jan 11, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 106605 | CA | Primary |
Addresses
Primary practice location
132 N Grant Ave
Manteca, CA 95336-4601
Mailing address
129 Mylnar Ave
Manteca, CA 95336-4908
Phone (209) 735-2798
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
| License | State | Type | Specialty |
|---|---|---|---|
| 106605 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641859200000",
"number": "1881345841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "129 MYLNAR AVE",
"city": "MANTECA",
"state": "CA",
"postal_code": "953364908",
"telephone_number": "209-735-2798"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 N GRANT AVE",
"city": "MANTECA",
"state": "CA",
"postal_code": "953364601",
"telephone_number": "209-239-5996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDHU",
"first_name": "JASJOT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-11",
"last_updated": "2022-01-11",
"certification_date": "2022-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "106605",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Manteca, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.