Individual provider Active NPI

Dhara Shah, D.M.D

  • General Practice Dentistry
  • Upton, MA
National Provider Identifier
1124457924
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11232 Issued in CT
Practice address
113 Main St Ste 7And7A
Upton, MA 01568-1621
Phone
(508) 529-4591
NPI assigned
Nov 2, 2013
Last updated
Mar 11, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 016.0099598 VT
General Practice Dentistry 1223G0001X 11232 CT Primary

Addresses

Primary practice location

113 Main St Ste 7And7A
Upton, MA 01568-1621

Mailing address

124 Newbury St Ste D
Peabody, MA 01960-4067
Phone (978) 278-5478

Other practice location 1

202 Pomfret St
Putnam, CT 06260-1833
Phone (860) 963-7917

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

LicenseStateTypeSpecialty
11232CTMDSocial Worker
016.0099598VTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Royal Dental Brookline PLLC General Practice Current Accepting new patients
Upton Dental Care PLLC Current Accepting new patients
Peabody Dental Spa, PLLC General Practice CurrentSince Apr 30, 2023 Accepting new patients

Locations

124 Newbury St
Ste D
Peabody, MA 01960
Phone (517) 316-6314

113 Main St
Ste 7AND7A
Upton, MA 01568
Phone (508) 529-4591

Organizations & group practices 3

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": "1383350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1124457924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NEWBURY ST STE D",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019604067",
            "telephone_number": "978-278-5478",
            "fax_number": "978-278-5714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MAIN ST STE 7AND7A",
            "city": "UPTON",
            "state": "MA",
            "postal_code": "015681621",
            "telephone_number": "508-529-4591"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "202 Pomfret St",
            "address_purpose": "LOCATION",
            "city": "Putnam",
            "state": "CT",
            "postal_code": "062601833",
            "country_code": "US",
            "telephone_number": "860-963-7917",
            "fax_number": "860-963-0015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DHARA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-02",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VT",
            "license": "016.0099598",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "11232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.