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NPI Code Detail

MEDICARE: DR. HANITA SIDANA D.M.D.

MEDICARE:  DR. HANITA  SIDANA  D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry53336CA
21223G0001XGeneral Practice Dentistry13524MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689682635
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HANITA SIDANA D.M.D.
Provider Business Mailing Address
First Line : 200 S WELLS RD
Second Line : #200
City : VENTURA
State : CA
Zip : 93004-1377
Country : US
Telephone Number : 805-659-1740
Fax Number : 805-659-3217
Provider Business Practice Location Address
First Line : 200 S WELLS RD
Second Line : #200
City : VENTURA
State : CA
Zip : 93004-1377
Country : US
Telephone Number : 805-659-1740
Fax Number : 805-659-3217
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2006
Last Update Date : 07/10/2014

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Directions to “ DR. HANITA SIDANA D.M.D.” Practice Location

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