Poonam Shah, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

64733 Issued in CA

Practice address

11600 Bandera Rd Ste 126
San Antonio, TX 78250-6806

Phone

(951) 316-9574

NPI assigned

Jul 19, 2015

Last updated

Feb 24, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1437264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582502400000",
    "number": "1417331497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 RUTH CIR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928798088",
            "telephone_number": "951-316-9574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11600 BANDERA RD STE 126",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782506806",
            "telephone_number": "951-316-9574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "POONAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-19",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meera Shah, PHARMD, BCIDP
• Milan Balkrishna Shah, M.D.
• Monisha Shah, MD
• Neel Shah, D.O.
• Neha Shah, PT
• Ravindra Shah, PHARMD
• Shafqat Shah, MD
• Shreya Rajesh Shah, PA-C
• Umang Hasmukhlal Shah, MD
• Vidur Shah, DO

• General Practice Dentistry in San Antonio, TX
• Providers in San Antonio, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.

Verify at the official NPI Registry.