Dhaval V Shah DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

DHAVAL V SHAH DMD PC

Doing business as

La Grange Family Dental

Practice address

310 W Burlington Ave
La Grange, IL 60525-2363

Phone

(708) 352-2223

NPI assigned

Apr 22, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Dhaval V Shah, DMDNPI 1063760080

Title

President

Phone

(630) 965-8133

Specialties & licenses 1

Addresses

Other names 1

• La Grange Family Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dhaval V Shah, D.M.D

  • Dentist
  • Romeoville, IL
  • NPI 1063760080

  General Practice

  NPD Authorized official
• Stephen Anthony Wallace, D.D.S.

  • Dentist
  • La Grange, IL
  • NPI 1780781831
  NPD (past)

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

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1710732938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16551 WILLOW DR",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604394649",
            "telephone_number": "630-965-8133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W BURLINGTON AVE",
            "city": "LA GRANGE",
            "state": "IL",
            "postal_code": "605252363",
            "telephone_number": "708-352-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DHAVAL V SHAH DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-21",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "DHAVAL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-965-8133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Grange Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lauren Elizabeth Desmith
• Margaret Caroline Devitt
• Sarah Rose Devivo, DMD
• Devon Acou DC, LLC
• Kelly Ann Dewolfe, APN
• Diabetic Eye Centers of America, Incorporated
• Tahyri Diaz, MD
• Richard A Disanto, PA-C
• Dominguez Development Group Incorporated
• David R Doyle, DPM

• General Practice Dentistry in La Grange, IL
• Providers in La Grange, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.