Shaheen Shafagh, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DS042966 Issued in PA

Practice address

100 S Eagle Rd
Havertown, PA 19083-3202

Phone

(104) 466-6886

Fax

(610) 446-6844

NPI assigned

Jul 6, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Orange St Dental Associates LLC

  • Dental Clinic/Center
  • Media, PA
  • NPI 1902659006
  NPD Authorized official
• Colorado Dental Partners LLC

  • Dental Clinic/Center
  • Littleton, CO
  • NPI 1346834074
  NPD (past)
• Sage Dentistry VI

  • Dentist
  • Arvada, CO
  • NPI 1285151290
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1013403666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 FAIRVIEW RD",
            "city": "PENN VALLEY",
            "state": "PA",
            "postal_code": "190721330",
            "telephone_number": "610-733-8877",
            "fax_number": "610-446-6844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S EAGLE RD",
            "city": "HAVERTOWN",
            "state": "PA",
            "postal_code": "190833202",
            "telephone_number": "104-466-6886",
            "fax_number": "610-446-6844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFAGH",
        "first_name": "SHAHEEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-07-06",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042966",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00203680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serenity Behavioral Health LLC
• Jennifer Sestito, MS
• Taylor Sforza
• Iraj Shafagh, DMD,MSC
• Jasmine Roxana Shafagh, DMD
• Khushbu Shah
• Valerie Suzanne Simonson Shah
• Francis Shannon
• Frank P Shannon, DDS
• Joellen Shannon

• Dentist in Havertown, PA
• Providers in Havertown, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.