Dr Srujal H Shah DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

58754 Issued in CA

Legal business name

DR SRUJAL H SHAH DDS INC

Practice address

101 Wilson Rd Ste D
Monterey, CA 93940-7873

Phone

(408) 490-0182

Fax

(408) 624-4545

NPI assigned

Jan 29, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Srujal Harshad Shah, DDSNPI 1457684623

Title

President

Phone

(408) 490-0182

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Dr Srujal H Shah DDS Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • San Jose, CA
  • NPI 1639480973

  4486840634

  Same PAC ID
• Dr Srujal H Shah DDS Inc

  • Dentist
  • Scotts Valley, CA
  • NPI 1710377494

  4486840634

  Same PAC ID
• Dr Srujal H Shah DDS Inc

  • Dentist
  • San Ramon, CA
  • NPI 1801286505

  4486840634

  Same PAC ID

Tax ID family

Dr Srujal H Shah DDS Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Dr Srujal H Shah DDS Inc

  • Dentist
  • Scotts Valley, CA
  • NPI 1710377494
  NPD tax ID
• Dr Srujal H Shah DDS Inc

  • Dentist
  • San Ramon, CA
  • NPI 1801286505
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Srujal Harshad Shah, DDS, DABDSM, DASBA

  • Dentist
  • San Jose, CA
  • NPI 1457684623
  NPD (past) Authorized official

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

{
    "created_epoch": "1422489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1528458403",
    "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": "101 WILSON RD STE D",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407873",
            "telephone_number": "408-490-0182",
            "fax_number": "408-624-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR SRUJAL H SHAH DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-29",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "SRUJAL",
        "authorized_official_middle_name": "HARSHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-490-0182",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "58754",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan E Dorey, RNFA
• Jason Doss
• Tatyana Latracee Downing
• Erica Downs-Karai, PSYD
• Timothy Doyle, P.T.
• Dr. George M Yellich DDS Ms Inc
• Dr. John J Eisinger DD.S., Inc.
• Dr. Richard Bianco D.M.D.
• Dr. Steven Chang DDS
• Dr. Steven H. Chang

• Dentist in Monterey, CA
• Providers in Monterey, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.