Individual provider Active NPI

Obaid Shah, DMD

  • Dentist
  • Chicago, IL
National Provider Identifier
1275061582
Registry record updated Apr 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.031828 Issued in IL
Practice address
5160 S Pulaski Rd Ste 102
Chicago, IL 60632-4253
Phone
(773) 423-2810
NPI assigned
May 31, 2017
Last updated
Apr 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.031828 IL Primary
General Practice Dentistry 1223G0001X 30.026328 OH

Addresses

Primary practice location

5160 S Pulaski Rd Ste 102
Chicago, IL 60632-4253

Mailing address

345 N Masters Dr
Addison, IL 60101-4117

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20170615002597 OH Order and Referring Only - DentistPractitioner - Dentist 8325316342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.031828ILMDDentist
30.026328OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Healthnet of Rock County, Inc. Dentist Current Accepting new patients
Healthnet of Rock County, Inc. Multi-Specialty Current Accepting new patients
All Kids Dental Center, LLC General Practice Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15975/brand/1/csg/1/fhir/r4
  • Direct secure messaging: obaid.shah.p29@direct.fhn-fqhc.nextgenshare.com

Organizations & group practices 3

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": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777507200000",
    "number": "1275061582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 N MASTERS DR",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601014117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5160 S PULASKI RD STE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606324253",
            "telephone_number": "773-423-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "OBAID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2026-04-30",
        "certification_date": "2026-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.031828",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.026328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.