Provider Demographics
NPI:1912550567
Name:SIDENT LLC
Entity Type:Organization
Organization Name:SIDENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:DR
Authorized Official - First Name:SALEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:SIRRI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-670-0641
Mailing Address - Street 1:8950 SW 74TH CT STE 1911
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33156-3178
Mailing Address - Country:US
Mailing Address - Phone:305-670-0641
Mailing Address - Fax:305-670-0641
Practice Address - Street 1:8257 S DIXIE HWY
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-7717
Practice Address - Country:US
Practice Address - Phone:305-667-4410
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIRRI DENTAL GROUP, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-23
Last Update Date:2019-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty