Deep I. Shah, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DS040290 Issued in PA

Practice address

1073 Oak St
Pittston, PA 18640-3716

Phone

(570) 654-4141

Fax

(570) 654-2150

NPI assigned

Mar 30, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Sidekick Smiles

  • Pediatric Dentistry
  • King of Prussia, PA
  • NPI 1801761853
  NPD Authorized official
• Casey Dental Institute P.C.

  • General Practice Dentistry
  • Pittston Township, PA
  • NPI 1417192725
  NPD (past)

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1679968465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CORNFIELD WAY",
            "address_2": "APT. 201",
            "city": "DALLAS",
            "state": "PA",
            "postal_code": "186127215",
            "telephone_number": "215-272-7446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1073 OAK ST",
            "city": "PITTSTON",
            "state": "PA",
            "postal_code": "186403716",
            "telephone_number": "570-654-4141",
            "fax_number": "570-654-2150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DEEP",
        "middle_name": "I.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS040290",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "PA",
            "license": "DS040290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Schmid, PA-C
• Matthew Joseph Schreck, PT
• Christine Elizabeth Schultz, BCBA
• Patrick Thomas Schwartz, MS, OTR/L
• Gabrielle Sedora
• Erica Shearer
• Sylvia Shemelewski
• Erin J Shepard, CRNP
• Mallory Shotwell
• Jessica Lee Shudak, PT

• Pediatric Dentistry in Pittston, PA
• Providers in Pittston, PA by specialty
• Pediatric Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.