Keyur Shodhan DDS Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

KEYUR SHODHAN DDS INC

Doing business as

Shodhan Dentistry

Practice address

11213 Palm Dr
Desert Hot Springs, CA 92240

Phone

(760) 251-2666

Fax

(760) 251-7655

NPI assigned

Jul 27, 2020

Last updated

Nov 3, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Keyur Shodhan, DDSNPI 1770640914

Title

Owner

Phone

(760) 251-2666

Specialties & licenses 1

Addresses

Other names 1

• Shodhan Dentistry Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keyur Shodhan, DDS

  • Dentist
  • Desert Hot Springs, CA
  • NPI 1770640914
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604361600000",
    "number": "1376152264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11213 PALM DR",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "92240",
            "telephone_number": "760-251-2666",
            "fax_number": "760-251-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11213 PALM DR",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "92240",
            "telephone_number": "760-251-2666",
            "fax_number": "760-251-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYUR SHODHAN DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A",
        "authorized_official_last_name": "SHODHAN",
        "authorized_official_first_name": "KEYUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-251-2666",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shodhan Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shodhan Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Athena Kakouris
• Mark Steven Kalkoske, PPS
• Matthew Gaire Keane, PHYSICIAN ASSISTANT
• Sarah Kee, RN
• Abbeygail Kemp
• Ennis Khaleq, PT
• Chu Yung Kim
• Ena Kim, MD
• Soo Jin Kim, PHARM.D
• Kathleen King, PHD, NCSP

• Dental Clinic/Center in Desert Hot Springs, CA
• Providers in Desert Hot Springs, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.