Individual provider Active NPI

Sheshaben A Shah, DDS

  • Dentist
  • Sun City, CA
National Provider Identifier
1265925804
Registry record updated Jan 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108282 Issued in CA
Practice address
28125 Bradley Rd Ste 210
Sun City, CA 92586-2248
Phone
(951) 679-0520
NPI assigned
Jun 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 108282 CA Primary

Addresses

Primary practice location

28125 Bradley Rd Ste 210
Sun City, CA 92586-2248

Mailing address

28125 Bradley Rd Ste 210
Sun City, CA 92586-2248
Phone (951) 679-0520

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

LicenseStateTypeSpecialty
108282CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
H. Pourshirazi DMD, Inc General Practice CurrentSince Jan 21, 2024 Accepting new patients
Simone Favor DDS LLC General Practice PastSince Mar 24, 2025 Accepting new patients

Locations

28125 Bradley Rd
Ste 210
Sun City, CA 92586
Phone (951) 679-0520

Organizations & group practices 2

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": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705708800000",
    "number": "1265925804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28125 BRADLEY RD STE 210",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862248",
            "telephone_number": "951-679-0520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28125 BRADLEY RD STE 210",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925862248",
            "telephone_number": "951-679-0520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHESHABEN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-08",
        "last_updated": "2024-01-20",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2024; 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.