Keyur Shodhan, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

B48380 Issued in CA

Practice address

12526 Palm Dr
Desert Hot Springs, CA 92240-4559

Phone

(760) 251-2666

Fax

(760) 251-7655

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Keyur Shodhan DDS Inc

  • Dental Clinic/Center
  • Desert Hot Springs, CA
  • NPI 1376152264
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1770640914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11213 PALM DR",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922403162",
            "telephone_number": "760-251-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12526 PALM DR",
            "city": "DESERT HOT SPRINGS",
            "state": "CA",
            "postal_code": "922404559",
            "telephone_number": "760-251-2666",
            "fax_number": "760-251-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHODHAN",
        "first_name": "KEYUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "B48380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "954842438",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deeana A Sawyer
• Christopher Allen Scott
• Madeline Shewchuk
• Robert Shields
• Harin Shodhan, D.D.S.
• Silas Gyimah MD Inc
• Lori B Siler
• Shannon Elizabeth Simmons
• Jaleesa Sims
• Juldene Z Sims, PPS

• Dentist in Desert Hot Springs, CA
• Providers in Desert Hot Springs, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.