Active NPI
Indra Sidhu, DDS
- General Practice Dentistry
- Laurel, MD
National Provider Identifier
1902056807
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 11295
- Practice address
- 595 Main St
Suite 237
Laurel, MD 20707-4352 - Phone
- (301) 498-0002
- NPI assigned
- Sep 26, 2008
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11295 | MD | Primary |
Addresses
Primary practice location
595 Main St
Suite 237
Laurel, MD 20707-4352
Mailing address
595 Main St
Suite 237
Laurel, MD 20707-4352
Phone (301) 498-0002
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11295 | Other | MD | STATE LICENCE |
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 |
|---|---|---|---|
| 11295 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Indra Sidhu DDS | Current | Accepting new patients | |
| Indra Sidhu DDS | General Practice | Current | Accepting new patients |
Locations
595 Main St
Ste 237
Laurel, MD 20707
Phone (301) 327-4555
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Glen Burnie, MD
- NPI 1699076307
-
- Dental Clinic/Center
- Glen Burnie, MD
- NPI 1053953372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1222387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1222387200000",
"number": "1902056807",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "595 MAIN ST",
"address_2": "SUITE 237",
"city": "LAUREL",
"state": "MD",
"postal_code": "207074352",
"telephone_number": "301-498-0002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 MAIN ST",
"address_2": "SUITE 237",
"city": "LAUREL",
"state": "MD",
"postal_code": "207074352",
"telephone_number": "301-498-0002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIDHU",
"first_name": "INDRA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-09-26",
"last_updated": "2008-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "11295",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENCE",
"identifier": "11295",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Laurel, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.