Sridhar Sista, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0025616 Issued in TX

Practice address

1355 W Gray St
Houston, TX 77019-4019

Phone

(713) 526-2904

NPI assigned

Jun 16, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1881915650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 W GRAY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770194019",
            "telephone_number": "713-526-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 W GRAY ST",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770194019",
            "telephone_number": "713-526-2904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISTA",
        "first_name": "SRIDHAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-16",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "0025616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ketal Sisodia
• Blandina Sison, MD
• Patricia Sison, LPT
• Therese Laine Sison
• Ashley Mani Sisoumphou
• Vinu Taneja Sista, DDS
• Sisters E&J Company LLC
• Sisters Home C Are
• Sisters Who Care Home Health Services
• Christen Sistrunk, M.A., LPC

• General Practice Dentistry in Houston, TX
• Providers in Houston, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.