Dr Srujal H Shah DDS Inc

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

58754 Issued in CA

Legal business name

DR SRUJAL H SHAH DDS INC

Doing business as

Spark Sleep Solutions

Practice address

6120 Hellyer Ave Ste 125
San Jose, CA 95138-1066

Phone

(408) 490-0182

Fax

(408) 624-4545

NPI assigned

Jul 1, 2010

Last updated

Oct 16, 2023By the provider in NPPES

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, D.D.S.NPI 1457684623

Title

President

Phone

(408) 490-0182

Specialties & licenses 2

Addresses

Other names 1

• Spark Sleep Solutions Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

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

  • Dentist
  • Monterey, CA
  • NPI 1528458403

  4486840634

  Same PAC ID
• Dr Srujal H Shah DDS Inc

  dba Spark Sleep Solutions

  • Dentist
  • Scotts Valley, CA
  • NPI 1710377494

  4486840634

  Same PAC ID
• Dr Srujal H Shah DDS Inc

  dba Spark Sleep Solutions

  • Dentist
  • San Ramon, CA
  • NPI 1801286505

  4486840634

  Same PAC ID

Tax ID family

Dr Srujal H Shah DDS Inc2 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.

• Mahdokht Yousefian DDS Inc.

  • Dentist
  • San Jose, CA
  • NPI 1861207771
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Srujal Harshad Shah, DDS, DABDSM, DASBA

  • Dentist
  • San Jose, CA
  • NPI 1457684623
  Medicare reassignment Care Compare group NPD Authorized official
• Jagruti P Upadhyay, D.D.S.

  • General Practice Dentistry
  • Fremont, CA
  • NPI 1235230186
  Medicare reassignment Care Compare group NPD
• Mahdokht Yousefian, DDS

  • General Practice Dentistry
  • Woodland Hills, CA
  • NPI 1992002539
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1639480973",
    "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": "6120 HELLYER AVE STE 125",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951381066",
            "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": "2010-07-01",
        "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": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "58754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spark Sleep Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Spark Sleep Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in San Jose, CA
• Providers in San Jose, CA by specialty
• Oral and Maxillofacial Surgery (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.