Shyam A. Shah, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02605700 Issued in NJ

Practice address

110 Bergen St RM B-854
Newark, NJ 07103-2495

Phone

(973) 972-4717

NPI assigned

Jun 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1433462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1104206010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST RM B-854",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495",
            "telephone_number": "973-972-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST RM B-854",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495",
            "telephone_number": "973-972-4717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Paterson Ave",
            "address_purpose": "LOCATION",
            "city": "Little Falls",
            "state": "NJ",
            "postal_code": "074244629",
            "country_code": "US",
            "telephone_number": "973-256-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHYAM",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-05",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02605700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandhya R Shah, MD
• Shailesh B. Shah, MS, RPH
• Shivani S Shah, DO
• Shreya Shah, MD
• Shriya M Shah, DPT
• Tulsi Shah, PHARMD
• Vaishali Parthiv Shah, M.D.
• Veevek Mukesh Shah, MD
• Vivek Shah, PHARMD
• Vraj P Shah, MD

• Dentist in Newark, NJ
• Providers in Newark, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.