Individual provider Active NPI

Amit D Shah, D.D.S

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1437466406
Registry record updated Sep 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59819 Issued in CA
Practice address
2821 S Hoover St Apt 205
Los Angeles, CA 90007-2449
Phone
(323) 578-7516
NPI assigned
Sep 10, 2010
Last updated
Sep 10, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 59819 CA Primary

Addresses

Primary practice location

2821 S Hoover St Apt 205
Los Angeles, CA 90007-2449

Mailing address

2821 S Hoover St Apt 205
Los Angeles, CA 90007-2449
Phone (323) 578-7516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20150818006206 WA Order and Referring Only - DentistPractitioner - Dentist 0143535211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59819CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1284076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284076800000",
    "number": "1437466406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2821 S HOOVER ST APT 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072449",
            "telephone_number": "323-578-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2821 S HOOVER ST APT 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900072449",
            "telephone_number": "323-578-7516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "AMIT",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-10",
        "last_updated": "2010-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.