NPIMap

Individual provider Active NPI

Shefali Bipin Shah, D.M.D.

  • Dentist
  • Rockford, IL
National Provider Identifier
1740621648
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.029568 Issued in IL
Practice address
6215 E State St
Rockford, IL 61108-2514
Phone
(815) 399-7777
NPI assigned
Jul 9, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019.029568 IL Primary

Addresses

Primary practice location

6215 E State St
Rockford, IL 61108-2514

Mailing address

350 N Clark St
6TH Floor
Chicago, IL 60654-4712
Phone (312) 274-4524

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019.029568ILMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
R & H Optometry PLLC Current Accepting new patients
WH Il Dental PLLC Dentist Current Accepting new patients
Dental Experts, LLC Past Accepting new patients
Dental Dreams LLC Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1740621648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N CLARK ST",
            "address_2": "6TH FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606544712",
            "telephone_number": "312-274-4524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6215 E STATE ST",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082514",
            "telephone_number": "815-399-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "SHEFALI",
        "middle_name": "BIPIN",
        "name_prefix": "Miss",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.029568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.