Active NPI
Mooni Dilip Shah, D.D.S.
- Dentist
- Georgetown, TX
National Provider Identifier
1164551867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 37201
- Practice address
- 1013 W University Ave Ste 345
Georgetown, TX 78628-5345 - Phone
- (512) 843-0062
- NPI assigned
- Mar 6, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 37201 | TX | Primary |
Addresses
Primary practice location
1013 W University Ave Ste 345
Georgetown, TX 78628-5345
Mailing address
288 Mount Vernon Way
Liberty Hill, TX 78642-6421
Phone (909) 260-4900
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170501000381 | NJ | Order and Referring Only - Dentist | 5496032419 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37201 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthy Smiles Family Dentistry | Dentist | Past | Accepting new patients |
| Dagv PA | General Practice | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- Voorhees, NJ
- NPI 1093971681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648080000000",
"number": "1164551867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "288 MOUNT VERNON WAY",
"city": "LIBERTY HILL",
"state": "TX",
"postal_code": "786426421",
"telephone_number": "909-260-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1013 W UNIVERSITY AVE STE 345",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786285345",
"telephone_number": "512-843-0062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "MOONI",
"middle_name": "DILIP",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2022-03-24",
"certification_date": "2022-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "37201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.