Individual provider Active NPI

Purvi Girish Shah, D.D.S

  • General Practice Dentistry
  • Riverside, CA
National Provider Identifier
1467885780
Registry record updated Oct 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62759 Issued in CA
Practice address
8735 Trautwein Rd
Riverside, CA 92508-9474
Phone
(951) 776-1330
Fax
(951) 776-1388
NPI assigned
Aug 11, 2013
Last updated
Oct 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2013

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 62759 CA Primary

Addresses

Primary practice location

8735 Trautwein Rd
Riverside, CA 92508-9474

Mailing address

8735 Trautwein Rd
Riverside, CA 92508-9474
Phone (951) 479-6096

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62759CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lynda Watanabe Professional Dental Corporation General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1376179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381104000000",
    "number": "1467885780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8735 TRAUTWEIN RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089474",
            "telephone_number": "951-479-6096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8735 TRAUTWEIN RD",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925089474",
            "telephone_number": "951-776-1330",
            "fax_number": "951-776-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PURVI",
        "middle_name": "GIRISH",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-11",
        "last_updated": "2013-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2013; 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.