Sejal U Shah DDS PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

048976-1 Issued in NY

Legal business name

SEJAL U SHAH DDS PC

Practice address

8820 169TH St
Jamaica, NY 11432-4431

Phone

(718) 739-6961

Fax

(718) 739-6958

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Sejal U Shah, DDS

Title

President

Phone

(718) 739-6961

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1033248844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81",
            "city": "ALBERTSON",
            "state": "NY",
            "postal_code": "115070081",
            "telephone_number": "718-739-6961",
            "fax_number": "718-739-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8820 169TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114324431",
            "telephone_number": "718-739-6961",
            "fax_number": "718-739-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEJAL U SHAH DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SEJAL",
        "authorized_official_middle_name": "U",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-739-6961",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "048976-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORALDENTAL",
            "identifier": "17958",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02145619",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.