Active NPI
Advait V. Shah, DMD
- Dentist
- Timonium, MD
National Provider Identifier
1285704056
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15215
- Practice address
- 16 Greenmeadow Dr
Suite 205
Timonium, MD 21093-3200 - Phone
- (410) 308-9955
- Fax
- (410) 308-9980
- NPI assigned
- Nov 9, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 053576 | NY | |
| Dentist | 122300000X | 15215 | MD | Primary |
| Dentist | 122300000X | 0401413923 | VA |
Addresses
Primary practice location
16 Greenmeadow Dr
Suite 205
Timonium, MD 21093-3200
Mailing address
16 Greenmeadow Dr
Suite 205
Timonium, MD 21093-3200
Phone (410) 308-9955
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15215 | MD | MD | Dentist |
| 053576 | NY | MD | Dentist |
| 0401413923 | VA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163030400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433376000000",
"number": "1285704056",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 GREENMEADOW DR",
"address_2": "SUITE 205",
"city": "TIMONIUM",
"state": "MD",
"postal_code": "210933200",
"telephone_number": "410-308-9955",
"fax_number": "410-308-9980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 GREENMEADOW DR",
"address_2": "SUITE 205",
"city": "TIMONIUM",
"state": "MD",
"postal_code": "210933200",
"telephone_number": "410-308-9955",
"fax_number": "410-308-9980"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "ADVAIT",
"middle_name": "V.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-09",
"last_updated": "2015-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "053576",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "15215",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "VA",
"license": "0401413923",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Timonium, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.