Individual
DR. EDIRIN ELAINE SIDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
D11121
OR
1223P0221X
Pediatric Dentistry
Primary
106959
CA
1223P0221X
Pediatric Dentistry
D11121
OR
1223P0221X
Pediatric Dentistry
DB-2023-0058
NM
Other
Enumeration date
04/23/2019
Last updated
05/30/2023
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