MEDICARE: SEJAL SIDHU

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
1	1223G0001X	General Practice Dentistry	6001836-15	WI

Other Identifiers

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

General Provider Information

NPI Number	:	1750267324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEJAL SIDHU

Provider Business Mailing Address
First Line	:	119 N MCCARTHY RD STE S
Second Line	:
City	:	APPLETON
State	:	WI
Zip	:	54913-9111
Country	:	US
Telephone Number	:	920-731-7445
Fax Number	:	920-404-2351

Provider Business Practice Location Address
First Line	:	550 CITY CTR
Second Line	:
City	:	OSHKOSH
State	:	WI
Zip	:	54901-4830
Country	:	US
Telephone Number	:	920-731-7445
Fax Number	:	920-651-3485

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	06/09/2026

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Directions to “ SEJAL SIDHU ” Practice Location

Language	Start Address	Practice Location

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