NPIMap

Organization Active NPI

Dipak S Shah DDS LTD

  • Dentist
  • Cicero, IL
National Provider Identifier
1609107010
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019-015412 Issued in IL
Legal business name
DIPAK S SHAH DDS LTD
Practice address
5539 W Cermak Rd
Cicero, IL 60804-2218
Phone
(708) 652-7575
Fax
(708) 652-7545
NPI assigned
Jan 25, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Authorized official

Name
Dr. Dipak S Shah, DDS
Title
President
Phone
(708) 652-7575

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019-015412 IL Primary

Addresses

Primary practice location

5539 W Cermak Rd
Cicero, IL 60804-2218

Mailing address

5539 W Cermak Rd
Cicero, IL 60804-2218
Phone (708) 652-7575

Other names 1

  • Central Dental Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Central Dental Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

5539 W Cermak Rd
Cicero, IL 60804
Phone (708) 652-7575

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1264377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264377600000",
    "number": "1609107010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5539 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042218",
            "telephone_number": "708-652-7575",
            "fax_number": "708-652-7545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5539 W CERMAK RD",
            "city": "CICERO",
            "state": "IL",
            "postal_code": "608042218",
            "telephone_number": "708-652-7575",
            "fax_number": "708-652-7545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIPAK S SHAH DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-25",
        "last_updated": "2010-01-25",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "DIPAK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-652-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019-015412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cicero, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2010; 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.