Brian S Shah, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

ME139554 Issued in FL

Practice address

131 2ND Ave S
St. Petersburg, FL 33701-4382

Phone

(727) 823-3220

Fax

(727) 823-7284

NPI assigned

Jun 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 17, 2019 through Apr 17, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Brian Shah, MD, PLLC

  • Oral and Maxillofacial Surgery Clinic/Center
  • Saint Petersburg, FL
  • NPI 1205573144
  NPD Authorized official
• Oral & Maxillofacial Surgery Associates PA

  • Oral and Maxillofacial Surgery (Dentist)
  • South Portland, ME
  • NPI 1780765495
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1104867431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 2ND AVE S",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337014382",
            "telephone_number": "727-823-3220",
            "fax_number": "727-823-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 2ND AVE S",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337014382",
            "telephone_number": "727-823-3220",
            "fax_number": "727-823-7284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BRIAN",
        "middle_name": "S",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IL",
            "license": "019.028191",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "IL",
            "license": "036.125106",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "ME139554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Serena Beth Shaffren, MD
• Asif Raza Shafiq, DO
• Ankur Shah
• Ashish Bhavesh Shah, M.D., M.B.A
• Bhavin D Shah
• Jaimin Girish Shah, MD
• Kanta C Shah, M.D.
• Kevin Shah
• Kunal Shah, MD
• Manan Shah, PHARMD

• Oral and Maxillofacial Surgery (Dentist) in St. Petersburg, FL
• Providers in St. Petersburg, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.