Individual provider Active NPI

Suhani K Shah, D.D.S.

  • General Practice Dentistry
  • Hayward, CA
National Provider Identifier
1184939092
Registry record updated Feb 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59591 Issued in CA
Practice address
19682 Hesperian Blvd Ste 106
Hayward, CA 94541-4752
Phone
(650) 450-0677
NPI assigned
Aug 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 59591 CA Primary

Addresses

Primary practice location

19682 Hesperian Blvd Ste 106
Hayward, CA 94541-4752

Mailing address

34173 Gannon Ter
Fremont, CA 94555-1943
Phone (650) 450-0677

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20211006001757 CA Practitioner - Oral SurgeryPractitioner - Dentist 2961800925 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59591CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Maria T Alarcon DDS Dental Corporation CurrentSince Aug 1, 2021 Accepting new patients

Locations

19682 Hesperian Blvd
Ste 106
Hayward Acres, CA 94541
Phone (510) 252-4003

19682 Hesperian Blvd
Ste 208
Hayward Acres, CA 94541
Phone (510) 253-2350

3927 Macdonald Ave
Richmond, CA 94805
Phone (510) 232-4003

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676073600000",
    "number": "1184939092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34173 GANNON TER",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945551943",
            "telephone_number": "650-450-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19682 HESPERIAN BLVD STE 106",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414752",
            "telephone_number": "650-450-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SUHANI",
        "middle_name": "K",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-16",
        "last_updated": "2023-02-11",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayward, CA

Sources for this page

Verify at the official NPI Registry.