Active NPI
Kavita A Shah, D.D.S.
- Dentist
- Canoga Park, CA
National Provider Identifier
1174736144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 47177
- Practice address
- 21001 Sherman Way Ste 13
Canoga Park, CA 91303-3680 - Phone
- (818) 346-7032
- Fax
- (818) 346-4835
- NPI assigned
- May 7, 2007
- Last updated
- Nov 28, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 47177 | CA | Primary |
Addresses
Primary practice location
21001 Sherman Way Ste 13
Canoga Park, CA 91303-3680
Mailing address
20941 Schoolcraft St
Canoga Park, CA 91303-2244
Phone (818) 212-0045
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47177 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322438400000",
"number": "1174736144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20941 SCHOOLCRAFT ST",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913032244",
"telephone_number": "818-212-0045"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21001 SHERMAN WAY STE 13",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913033680",
"telephone_number": "818-346-7032",
"fax_number": "818-346-4835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "KAVITA",
"middle_name": "A",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-07",
"last_updated": "2011-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "47177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canoga Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.