Bharat R Shah I, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN11696 Issued in FL

Practice address

3000 Dunn Ave Ste 38
Jacksonville, FL 32218-6551

Phone

(904) 768-3790

Fax

(904) 768-7132

NPI assigned

Jul 17, 2006

Last updated

May 27, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Practice roles

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.

• Dr. B. R. Shah

  • Dentist
  • Jacksonville, FL
  • NPI 1932364957
  NPD (past) Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1174541296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 DUNN AVE STE 38",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186551",
            "telephone_number": "904-768-3790",
            "fax_number": "904-768-7132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 DUNN AVE STE 38",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322186551",
            "telephone_number": "904-768-3790",
            "fax_number": "904-768-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "BHARAT",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN11696",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN11696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071934000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anjali Shah Patel, OD
• Andrea Ellen Clark Shah, M.D.
• Antra Jignesh Shah
• Atif A Shah, MD
• Atul Mukutbhai Shah, MD
• Dhaval Yogeshkumar Shah, DMD
• Dipam Jashwant Shah, AA
• Faiza Shah, M.D.
• Hardik C Shah, M.D.
• Hemant N Shah, M.D.

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.