Mariyam Shah, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401417108 Issued in VA

Practice address

8111 Midlothian Tpke
North Chesterfield, VA 23235-5115

Phone

(804) 918-9667

NPI assigned

Jul 28, 2020

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ideal Dental Care , Inc

  • Preferred Provider Organization
  • North Chesterfield, VA
  • NPI 1780045849
  NPD (past)

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1639788334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3825 NIGHTMUSE WAY",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230594800",
            "telephone_number": "713-548-7184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 MIDLOTHIAN TPKE",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232355115",
            "telephone_number": "804-918-9667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MARIYAM",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401417108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Serkes, M.D.
• Ashish Sethi
• Seven Wellness, LLC
• Nancy Shaffer, MD
• Alap Pravin Shah, MD
• Saumil R Shah, M.D.
• Vishala Shah
• Seth Shaltes
• Domique Shannon, MSW, SUPERVISEE
• Erin Sharkey, DDS

• Dentist in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; 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.