Steven Luby Sidoff Sr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

14992 Issued in TX

Practice address

3145 Garden Ave
1278
Fort Sam Houston, TX 78234-7718

Phone

(210) 808-3735

Fax

(210) 808-3802

NPI assigned

Feb 21, 2006

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398384000000",
    "number": "1922073279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15811 PONDEROSA PASS",
            "city": "HELOTES",
            "state": "TX",
            "postal_code": "780233685",
            "telephone_number": "847-274-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3145 GARDEN AVE",
            "address_2": "1278",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347718",
            "telephone_number": "210-808-3735",
            "fax_number": "210-808-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDOFF",
        "first_name": "STEVEN",
        "middle_name": "LUBY",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2014-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "14992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary David Short, PA-C
• Tajuana T Shuler, DNP, PMHNP-BC
• Lena Scurry Shumate, CCC-A
• Theresa C. Sidberry, M.D.
• Ryan Sides
• Jordan Silverman, MD
• Matthew Louis Silverman, MD
• Alyssa Simon, IDMT
• Janet Jones Sims, CRNA
• Pranav Singh, MD

• Dentist in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.