Srujal Harshad Shah, DDS, DABDSM, DASBA

Primary specialty

DentistTaxonomy code 122300000X

License

58754 Issued in CA

Practice address

6120 Hellyer Ave Ste 125
San Jose, CA 95138-1066

Phone

(408) 490-0182

Fax

(408) 624-4545

NPI assigned

Sep 4, 2009

Last updated

Oct 16, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Oral Surgery

Education

Univ of Calif, Los Angeles School of Dentistry, 2008

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Dr Srujal H Shah DDS IncGroup PAC ID 4486840634, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Srujal H Shah DDS Inc

  dba Spark Sleep Solutions

  • Oral and Maxillofacial Surgery (Dentist)
  • San Jose, CA
  • NPI 1639480973
  Medicare reassignment Care Compare group NPD Authorized official
• Dr Srujal H Shah DDS Inc

  dba Spark Sleep Solutions

  • Dentist
  • San Ramon, CA
  • NPI 1801286505
  NPD Authorized official
• Dr Srujal H Shah DDS Inc

  • Dentist
  • Monterey, CA
  • NPI 1528458403
  NPD (past) Authorized official
• Dr Srujal H Shah DDS Inc

  dba Spark Sleep Solutions

  • Dentist
  • Scotts Valley, CA
  • NPI 1710377494
  NPD (past) Authorized official
• County of Santa Clara

  dba Inpatient Acute/Outpatient Facility Services

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  NPD (past)
• El Camino Hospital

  dba El Camino Health

  • General Acute Care Hospital
  • Mountain View, CA
  • NPI 1093712374
  NPD (past)

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

{
    "created_epoch": "1252022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1457684623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6120 HELLYER AVE STE 125",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381066",
            "telephone_number": "408-490-0182",
            "fax_number": "408-624-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6120 HELLYER AVE STE 125",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381066",
            "telephone_number": "408-490-0182",
            "fax_number": "408-624-4545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Pollard Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Los Gatos",
            "state": "CA",
            "postal_code": "950321435",
            "country_code": "US",
            "telephone_number": "408-490-0182",
            "fax_number": "408-624-4545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4340 Scotts Valley Dr Ste H",
            "address_purpose": "LOCATION",
            "city": "Scotts Valley",
            "state": "CA",
            "postal_code": "950664541",
            "country_code": "US",
            "telephone_number": "408-490-0182",
            "fax_number": "408-624-4545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1081 Market Pl Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Ramon",
            "state": "CA",
            "postal_code": "945834749",
            "country_code": "US",
            "telephone_number": "408-490-0182",
            "fax_number": "408-624-4545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Wilson Rd",
            "address_purpose": "LOCATION",
            "city": "Monterey",
            "state": "CA",
            "postal_code": "939407864",
            "country_code": "US",
            "telephone_number": "408-490-0182",
            "fax_number": "408-624-4545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SRUJAL",
        "middle_name": "HARSHAD",
        "name_prefix": "Dr.",
        "credential": "DDS, DABDSM, DASBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-04",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58754",
            "primary": true
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "CA",
            "license": "58754",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shaili Shah, M.D.
• Sharmin Shah, MS, RD
• Shayena Shah, MD
• Shital H. Shah, RPH
• Siddhi Shah, P.T.
• Tanvi Shah
• Vrajesh Jatin Shah, MD
• Zainab Shah
• Ebrahim Shahbazpour
• Michael Mohammed Shaheed, BA; MSW STUDENT

• Dentist in San Jose, CA
• Providers in San Jose, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.