Individual provider Active NPI

Dhwani Jatin Shah, DDS

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1255996302
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36095 Issued in TX
Practice address
2222 Welborn St
Dallas, TX 75219-3924
Phone
(214) 559-5000
Fax
(214) 443-7309
NPI assigned
May 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 36095 TX Primary

Addresses

Primary practice location

2222 Welborn St
Dallas, TX 75219-3924

Mailing address

2222 Welborn St
Dallas, TX 75219-3924
Phone (214) 559-5000

Other practice location 1

11201 Benton St
Loma Linda, CA 92357-1000
Phone (909) 825-7084

Other practice location 2

5700 Dallas Pkwy
Frisco, TX 75034-9580
Phone (469) 515-7100

Other practice location 3

3800 Gaylord Pkwy Ste 850
Frisco, TX 75034-0248
Phone (469) 857-2222

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
I20241111000653 TX Practitioner - Dentist 9032643283 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Scottish Rite Hospital for Crippled Children CurrentSince Sep 1, 2024 Accepting new patients

Locations

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

3800 Gaylord Pkwy
Ste 850
Frisco, TX 75034
Phone (469) 857-2222

5700 Dallas Pkwy
Frisco, TX 75034
Phone (469) 515-7100

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": "1556841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1255996302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 WELBORN ST",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752193924",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11201 Benton St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923571000",
            "country_code": "US",
            "telephone_number": "909-825-7084",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5700 Dallas Pkwy",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750349580",
            "country_code": "US",
            "telephone_number": "469-515-7100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 Gaylord Pkwy Ste 850",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750340248",
            "country_code": "US",
            "telephone_number": "469-857-2222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DHWANI",
        "middle_name": "JATIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-03",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.