Provider Demographics
NPI:1750502928
Name:KAKANI, SIDDHARTHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SIDDHARTHA
Middle Name:
Last Name:KAKANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 NORTH 95TH PLAZA # 5
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114
Mailing Address - Country:US
Mailing Address - Phone:402-650-8157
Mailing Address - Fax:
Practice Address - Street 1:CREIGHTON UNIVERSITY MEDICAL CENTER
Practice Address - Street 2:601 NORTH 30TH STREET
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131
Practice Address - Country:US
Practice Address - Phone:402-280-4392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4971207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine