Active NPI
Kinjal Nimish Shah, D.D.S.
- General Practice Dentistry
- Severn, MD
National Provider Identifier
1104003854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 13038
- Practice address
- 2622 Annapolis Road Apple Dental
Suite-I
Severn, MD 21144 - Phone
- (410) 551-7076
- Fax
- (410) 510-1010
- NPI assigned
- Jan 24, 2008
- Last updated
- Sep 29, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 13038 | MD | Primary |
Addresses
Primary practice location
2622 Annapolis Road Apple Dental
Suite-I
Severn, MD 21144
Mailing address
2622 Annapolis Road Apple Dental
Suite-I
Severn, MD 21144
Phone (410) 551-7076
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13038 | MD | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K3Ndental LLC | General Practice | Current | Accepting new patients |
Locations
2622 Annapolis Rd
#I
Severn, MD 21144
Phone (410) 551-7076
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695945600000",
"number": "1104003854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2622 ANNAPOLIS ROAD APPLE DENTAL",
"address_2": "SUITE-I",
"city": "SEVERN",
"state": "MD",
"postal_code": "21144",
"telephone_number": "410-551-7076",
"fax_number": "410-551-7076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2622 ANNAPOLIS ROAD APPLE DENTAL",
"address_2": "SUITE-I",
"city": "SEVERN",
"state": "MD",
"postal_code": "21144",
"telephone_number": "410-551-7076",
"fax_number": "410-510-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "KINJAL",
"middle_name": "NIMISH",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-24",
"last_updated": "2023-09-29",
"certification_date": "2023-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MD",
"license": "13038",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severn, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.