Provider Demographics
NPI:1366676611
Name:DOSHI, SIDDHI JYOTINDRA (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SIDDHI
Middle Name:JYOTINDRA
Last Name:DOSHI
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:692 N MIDVALE BLVD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-3200
Mailing Address - Country:US
Mailing Address - Phone:847-800-7433
Mailing Address - Fax:
Practice Address - Street 1:100 WILBURN RD
Practice Address - Street 2:
Practice Address - City:SUN PRAIRIE
Practice Address - State:WI
Practice Address - Zip Code:53590-1478
Practice Address - Country:US
Practice Address - Phone:847-800-7433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-14
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6361-0151223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics