Active NPI
Obaid Shah, DMD
- Dentist
- Chicago, IL
National Provider Identifier
1275061582
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.031828
- 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, 2026
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170615002597 | OH | Order and Referring Only - Dentist | 8325316342 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.031828 | IL | MD | Dentist |
| 30.026328 | OH | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New 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
- https://api.platform.athenahealth.com/15975/brand/1/csg/1/fhir/r4
- 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.
-
- Dentist
- Janesville, WI
- NPI 1205285699
-
- General Practice Dentistry
- Melrose Park, IL
- NPI 1003246927
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.