Harsh Shah, D.M.D.
Individual provider Active NPI General Practice Dentistry · Branchville, NJ
NPI 1720379449 · NPPES record last updated Aug 12, 2011
Key facts
- NPI
- 1720379449
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 22DI02468400 (NJ)
- Practice address
- 1 Country LN
Branchville, NJ 07826-4237 - Phone
- (973) 948-5000
- NPI assigned
- Apr 28, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02468400 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Suite Tooth, LLC | General Practice | Past |
Accepting new patients |
| Okeson Family Dental, PC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02468400 | NJ | Yes |
Addresses
Primary practice location
1 Country LN
Branchville, NJ 07826-4237
Mailing address
77 Pennington Ave Apt C4
Passaic, NJ 07055-8834
Phone (973) 594-8384
Other providers in Branchville, NJ
- Scarc, Inc.
- Scarc, Inc.
- Scarc, Inc.
- Scarc, Inc.
- Jean Louise Schmidt
- Arnold Allen Soldavin
- Kim Rahuba Stetzel
- Katie Struble
- The Suite Tooth, LLC
- Mark Anthony Thogode
All providers in Branchville, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.