Shahnam Alexander Shifteh, DDS
Individual provider Active NPI General Practice Dentistry · River Vale, NJ
NPI 1023364288 · NPPES record last updated Jul 25, 2012
Key facts
- NPI
- 1023364288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 056166 (NJ)
- Practice address
- 16 Holiday CT
River Vale, NJ 07675-5708 - Phone
- (201) 264-5270
- NPI assigned
- Jul 25, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056166 | NJ | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 056166 | NJ | Yes |
Addresses
Primary practice location
16 Holiday CT
River Vale, NJ 07675-5708
Mailing address
16 Holiday CT
River Vale, NJ 07675-5708
Phone (201) 264-5270
Other providers in River Vale, NJ
- Pivot Livestyle and Rehabilitation LLC
- Molly Reiter
- River Vale Eyecare
- Nak Seon Seong
- Amy Reisa Shames
- Joseph M Skellie
- Spark Acupuncture Associates LLC
- Spectrum for Living Development, Inc.
- Spectrum for Living Development, Inc.
- Spectrum for Living Development, Inc.
All providers in River Vale, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.