Pathik Shah, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS041694 Issued in PA

Practice address

6818 Castor Ave
Philadelphia, PA 19149-2106

Phone

(240) 630-2435

NPI assigned

Aug 14, 2014

Last updated

May 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Abz Dental PLLC

  dba Prime Dentistry

  • General Practice Dentistry
  • Philadelphia, PA
  • NPI 1811531114
  NPD Authorized official
• Uptown Family Dentistry

  • General Practice Dentistry
  • Harrisburg, PA
  • NPI 1639321672
  NPD (past)

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620950400000",
    "number": "1629477815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6818 CASTOR AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492106",
            "telephone_number": "215-742-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6818 CASTOR AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191492106",
            "telephone_number": "240-630-2435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PATHIK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2021-05-14",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS041694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nisha Shah, DO
• Nishit P Shah, M.D.
• Palav Jitendra Shah, DO
• Paras D Shah, DO
• Pari Mayank Shah, MD
• Pavan P Shah, MD
• Payal Deepak Shah, MD
• Payal Vipul Shah, MD
• Pooja Viral Shah
• Pratik A. Shah, OD

• General Practice Dentistry in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.