NPIMap

Organization Active NPI

Amit Lalit Shah DDS Inc

  • Dentist
  • Tustin, CA
National Provider Identifier
1225166127
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
49805 Issued in CA
Legal business name
AMIT LALIT SHAH DDS INC
Practice address
17601 17TH St Ste 100
Tustin, CA 92780-1946
Phone
(714) 544-7511
Fax
(714) 544-8918
NPI assigned
Mar 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Authorized official

Name
Amit Lalit ShahNPI 1437207701
Title
Owner
Phone
(562) 694-3984

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 49805 CA Primary

Addresses

Primary practice location

17601 17TH St Ste 100
Tustin, CA 92780-1946

Mailing address

17601 17TH St Ste 100
Tustin, CA 92780-1946
Phone (714) 544-7511

Other identifiers 1

IdentifierTypeStateIssuer
G9331401OtherCAMEDICAL

Other names 1

  • Tustin Smiles dental office of Dr. Shah Doing business as

National Provider Directory

National Provider Directory

Locations

17601 17th St
Ste 100
Tustin, CA 92780
Phone (714) 544-7511

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1225166127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17601 17TH ST STE 100",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801946",
            "telephone_number": "714-544-7511",
            "fax_number": "714-544-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17601 17TH ST STE 100",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927801946",
            "telephone_number": "714-544-7511",
            "fax_number": "714-544-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIT LALIT SHAH DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "AMIT",
        "authorized_official_middle_name": "LALIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-694-3984"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "49805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "G9331401",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tustin Smiles dental office of Dr. Shah",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.