SIDHARTH MOHAN (NPI# 1558830794) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558830794 |
| Entity Type | Individual |
| Full Name | SIDHARTH MOHAN |
| Credential | MSD, BDS, BS |
| Practice Address |
964 Brookforest Ave Shorewood IL 60404-8807 |
| Practice Telephone | 8152541177 |
| Mailing Telephone | 8649408987 |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2019-10-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 019.031930 | IL | Dental Providers |
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
019.031930 | IL | Dental Providers |
| Street Address |
964 BROOKFOREST AVE |
| City | SHOREWOOD |
| State | IL |
| Zip Code | 60404-8807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669035242 | Mobile Dental Care of Delaware, Pa | Dentist | 18622 S. Rte 59 Unit A-1, Shorewood, IL 60404 | 2019-04-18 |
| 1326476755 | Christine Briski | Speech-Language Pathologist | 210 W Black Road, Shorewood, IL 60404 | 2013-10-22 |
| 1598000630 | Michael G Mcdowell | Nurse Practitioner | 1039 Brookforest Ave, Shorewood, IL 60404 | 2012-11-29 |
| 1699028910 | Patti-ann Ebert | Occupational Therapist | 850 Brook Forest Ave., Unit L, Shorewood, IL 60404 | 2012-10-24 |
| 1043567720 | Matthew Reiot Klebenow | Occupational Therapist | 852a Sharp Drive, Provena Physical Therapy & Industrial Rehab. Center, Shorewood, IL 60404 | 2012-08-13 |
| 1366728222 | Linda K Alonso | Pharmacist | 1160 W. Jefferson St., Shorewood, IL 60404 | 2011-10-24 |
| 1205110186 | Lanie R Moreno | Physical Therapist | 850 Brookforest Ave Unit L, Shorewood, IL 60404 | 2011-10-10 |
| 1932386810 | Advanced Family Dental of Shorewood, P.C. | Dentist | 150 N Brook Forest Drive, Shorewood, IL 60404 | 2008-01-23 |
| 1003025941 | Kerri Lanum | Specialist/Technologist | 850 Brookforest Ave. F, Shorewood, IL 60404 | 2007-05-21 |
| 1124246756 | Alexander Grabavoy | Dentist | 1007 W. Jefferson Street, Shorewood, IL 60404 | 2007-04-20 |
| Find all providers in zip 60404 | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811426810 | Carolyn Griffin Dds LLC | Dentist | 1720 E Lake Bluff Blvd, Shorewood, WI 53211-1517 | 2017-06-05 |
| 1619023082 | Timothy O. Hart Dds Ms, Ltd | Dentist | 1720 E Lake Bluff Blvd, Shorewood, WI 53211-1517 | 2007-01-26 |
| 1134275597 | Timothy Otto Hart | Dentist | 1720 E Lake Bluff Blvd, Shorewood, WI 53211-1517 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164039947 | Yale Cho | Dentist | 17w110 22nd St Ste 150, Oakbrook Terrace, IL 60181-4454 | 2020-09-25 |
| 1720622152 | Sandra Altarawneh | Dentist | Uic College of Dentistry, 801 S. Paulina Street, Chicago, IL 60612 | 2019-10-29 |
| 1841848355 | Prime Dental Specialists | Dentist | 2638 Patriot Blvd, Glenview, IL 60026-8024 | 2019-08-28 |
| 1578047882 | Mohammed Salih | Dentist | 4408 W Lawrence Ave Ste 2, Chicago, IL 60630-2511 | 2018-09-21 |
| 1396256350 | Christopher William Coffey | Dentist | 14600 S La Grange Rd Ste 5, Orland Park, IL 60462-2580 | 2017-10-18 |
| 1801349196 | Delsaz Sultan | Dentist | 1301 W 22nd St Ste 1007, Oak Brook, IL 60523 | 2016-08-03 |
| 1578985495 | Fransiskus Andrianto Tjiptowidjojo | Dentist | 1901 N Roselle Rd Ste 110, Schaumburg, IL 60195-3179 | 2014-01-11 |
| 1386079689 | Bryan Jacobs | Dentist | 4905 Old Orchard Ctr Ste 728, Skokie, IL 60077-4734 | 2013-09-05 |
| 1790932325 | Samson Sol Flores | Dentist | 1415 Oakton St, Evanston, IL 60202-2720 | 2008-08-26 |
| 1396991196 | Lake Forest Dental Associates, PC | Dentist | 133 E Laurel Ave, Lake Forest, IL 60045-1205 | 2008-08-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.