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General NPI Number Information
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NPI Number | 1992449995
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Entity Type | Individual
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Provider Name | MADEEHA SIDDIQUI DDS
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Gender | Female
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Dates
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Enumeration Date | 04/25/2022
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 3687 LAS POSAS RD
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City | CAMARILLO
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State | CA
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Zip | 93010-1482
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Country | US
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Telephone | 805-738-9500
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Fax |
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Provider Business Mailing Address
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Address Line | 2749 ROCKY POINT CT
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-4943
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Country | US
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Telephone | 805-807-9912
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 109975
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License Number State | CA
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