Individual provider Active NPI

Azam Amin Shah, D.D.S.

  • Dentist
  • Houston, TX
National Provider Identifier
1205882198
Registry record updated Aug 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
20232 Issued in TX
Practice address
2300 Richmond Ave
Apt 342
Houston, TX 77098-3265
Phone
(832) 687-6384
NPI assigned
May 25, 2006
Last updated
Aug 4, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 20232 TX Primary

Addresses

Primary practice location

2300 Richmond Ave
Apt 342
Houston, TX 77098-3265

Mailing address

2300 Richmond Ave
Apt 342
Houston, TX 77098-3265
Phone (713) 223-1700

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
I20160201001492 TX Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 1254635980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20232TXMDProfessional Counselor

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": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1205882198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 RICHMOND AVE",
            "address_2": "APT 342",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983265",
            "telephone_number": "713-223-1700",
            "fax_number": "713-223-5746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 RICHMOND AVE",
            "address_2": "APT 342",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770983265",
            "telephone_number": "832-687-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "AZAM",
        "middle_name": "AMIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "20232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.