Individual provider Active NPI

Suvidha Sachdeva, DDS

  • General Practice Dentistry
  • Roswell, GA
National Provider Identifier
1962633214
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN014634 Issued in GA
Practice address
365 Market PL Ste 100
Roswell, GA 30075-3947
Phone
(770) 998-8116
NPI assigned
Aug 5, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN014634 GA Primary
General Practice Dentistry 1223G0001X 2901020071 MI

Addresses

Primary practice location

365 Market PL Ste 100
Roswell, GA 30075-3947

Mailing address

365 Market PL Ste 100
Roswell, GA 30075-3947
Phone (770) 998-8116

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20151221001855 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3476854266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN014634GAMDGeneral Practice Dentistry
2901020071MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sunshine Smiles Dentistry CurrentSince Jul 9, 2023 Accepting new patients

Locations

365 Market Pl
Ste 100
Roswell, GA 30075
Phone (770) 998-8116

1190 Grimes Bridge Rd
Ste B
Roswell, GA 30075
Phone (770) 998-8116

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1962633214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 MARKET PL STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753947",
            "telephone_number": "770-998-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 MARKET PL STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753947",
            "telephone_number": "770-998-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACHDEVA",
        "first_name": "SUVIDHA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014634",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901020071",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

Verify at the official NPI Registry.