Sagar M. Shah, Dentist P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

056704 Issued in NY

Legal business name

SAGAR M. SHAH, DENTIST P.C.

Practice address

8935 164TH St
Jamaica, NY 11432-5141

Phone

(516) 410-7586

NPI assigned

May 5, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Sagar Shah, DMD

Title

Dentist / Owner

Phone

(516) 410-7586

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493942400000",
    "number": "1326574682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8935 164TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8935 164TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325141",
            "telephone_number": "516-410-7586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAGAR M. SHAH, DENTIST P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-05",
        "last_updated": "2017-05-05",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SAGAR",
        "authorized_official_title_or_position": "DENTIST / OWNER",
        "authorized_official_telephone_number": "516-410-7586",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "056704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03706654",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; 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.