Jesal Shah, DMD, P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

052986 Issued in NY

Legal business name

JESAL SHAH, DMD, P.C.

Practice address

4609 5TH Ave
2ND Floor
Brooklyn, NY 11220-1207

Phone

(718) 854-3191

Fax

(718) 909-1635

NPI assigned

Nov 21, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jesal Shah, DMD

Title

President

Phone

(516) 395-2659

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1366985491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 5TH AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112201207",
            "telephone_number": "718-854-3191",
            "fax_number": "718-909-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 5TH AVE",
            "address_2": "2ND FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112201207",
            "telephone_number": "718-854-3191",
            "fax_number": "718-909-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESAL SHAH, DMD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "JESAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-395-2659",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "052986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03476693",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gracie Jersey
• Chavie Jerusalem, MSED
• Gittle Jerusalem
• Leah Jerusalem
• Ramiro Jervis, MD
• Stuart Joseph Jesin, M.D.
• Amy Melissa Jesiolowski, BCBA
• Hassan Naushad Jessani
• Jessica Purpura LLC
• Jessica Welker Mental Health Counseling, PLLC

• Oral and Maxillofacial Surgery (Dentist) in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.