Individual provider Active NPI

Chintan Piyush Shah, D.D.S.

  • Dentist
  • Burton, MI
National Provider Identifier
1518307404
Registry record updated Oct 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901021058 Issued in MI
Practice address
5136 Davison Rd
Burton, MI 48509-1569
Phone
(810) 742-6060
Fax
(810) 742-3022
NPI assigned
Jun 25, 2013
Last updated
Oct 13, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901021058 MI Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

5136 Davison Rd
Burton, MI 48509-1569

Mailing address

5136 Davison Rd
Burton, MI 48509-1569
Phone (810) 742-6060

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160202000347 MI Order and Referring Only - DentistPractitioner - Dentist 2365746955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Burton Family Dental PLLC CurrentSince Jul 24, 2022 Accepting new patients
John M. Sullivan DDS, PLLC Dentist CurrentSince Oct 20, 2019 Accepting new patients

Locations

5136 Davison Rd
Burton, MI 48509
Phone (810) 742-6060

Organizations & group practices 2

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": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570924800000",
    "number": "1518307404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5136 DAVISON RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091569",
            "telephone_number": "810-742-6060",
            "fax_number": "810-742-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5136 DAVISON RD",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091569",
            "telephone_number": "810-742-6060",
            "fax_number": "810-742-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "CHINTAN",
        "middle_name": "PIYUSH",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2019-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901021058",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

Verify at the official NPI Registry.