Individual provider Active NPI

Shivani C Shah, D.D.S

  • Dentist
  • Houston, TX
National Provider Identifier
1164652954
Registry record updated Feb 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24766 Issued in TX
Practice address
12805 Cullen Blvd
Ste E
Houston, TX 77047-3759
Phone
(713) 264-7333
NPI assigned
Jul 15, 2009
Last updated
Feb 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 24766 TX Primary

Addresses

Primary practice location

12805 Cullen Blvd
Ste E
Houston, TX 77047-3759

Mailing address

4310 N Shadow Mist LN
Sugar Land, TX 77479-4570
Phone (832) 725-8621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20151124002738 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7911207865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24766TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Oyster Creek Dentistry Past Accepting new patients

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330387200000",
    "number": "1164652954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 N SHADOW MIST LN",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774794570",
            "telephone_number": "832-725-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 CULLEN BLVD",
            "address_2": "STE E",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770473759",
            "telephone_number": "713-264-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHIVANI",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2012-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "24766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.