Jalak Shah, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D012307 Issued in AZ

Practice address

1240 E Baseline Rd Ste 100
Mesa, AZ 85204-6700

Phone

(480) 576-7378

NPI assigned

Aug 14, 2024

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

Locations

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.

• Mesa Grand Kids Dentistry and Orthodontics Az LLP

  • General Practice Dentistry
  • Mesa, AZ
  • NPI 1912649807
  NPD

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

{
    "created_epoch": "1723593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1659103174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N CENTRAL AVE APT 908",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850042765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 E BASELINE RD STE 100",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852046700",
            "telephone_number": "480-576-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "JALAK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-14",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D012307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahzad Shadmany, MD
• James W Shafer, MD
• Rod Shafer, R.PH.
• Lisa Shaffer
• Bhavish Shah, MD
• Kunjan Shah, M.D.
• Mikulkumar D Shah, MD
• Prakash Shantilal Shah, MD
• Ruchit Shah
• Sanjay J Shah, MD

• General Practice Dentistry in Mesa, AZ
• Providers in Mesa, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; 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.