Healthcare Provider Details
I. General information
NPI: 1841120904
Provider Name (Legal Business Name): GIDEON SAIDARA DDS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
445 W PALMDALE BLVD STE D
PALMDALE CA
93551-4509
US
IV. Provider business mailing address
445 W PALMDALE BLVD STE D
PALMDALE CA
93551-4509
US
V. Phone/Fax
- Phone: 310-600-1095
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GIDEON
SAIDARA
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 310-600-1095