Active NPI
Nisha Shah
- Dentist
- Wakefield, MA
National Provider Identifier
1538736905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN1859003
- Practice address
- 409 Main St
Wakefield, MA 01880-3017 - Phone
- (781) 850-4037
- NPI assigned
- Jun 5, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN1859003 | MA | Primary |
Addresses
Primary practice location
409 Main St
Wakefield, MA 01880-3017
Mailing address
36 Dartmouth St Apt 1011
Malden, MA 02148-5115
Phone (781) 224-0021
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN1859003 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 42 North Dental Care, LLC | 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 and National Provider Directory roles.
-
dba Gentle Dental Wakefield
- Dental Clinic/Center
- Wakefield, MA
- NPI 1194094854
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642377600000",
"number": "1538736905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 DARTMOUTH ST APT 1011",
"city": "MALDEN",
"state": "MA",
"postal_code": "021485115",
"telephone_number": "781-224-0021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 MAIN ST",
"city": "WAKEFIELD",
"state": "MA",
"postal_code": "018803017",
"telephone_number": "781-850-4037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "NISHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-05",
"last_updated": "2022-01-17",
"certification_date": "2022-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1859003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wakefield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.