Individual provider Active NPI

Shamshudin Kherani, DDS

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1841587425
Registry record updated Jul 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5735 Issued in NV
Practice address
1401 Hillshire Dr
Las Vegas, NV 89134-6365
Phone
(650) 204-0726
Fax
(702) 202-2506
NPI assigned
Jul 5, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5735 NV Primary
General Practice Dentistry 1223G0001X 57908 CA

Addresses

Primary practice location

1401 Hillshire Dr
Las Vegas, NV 89134-6365

Mailing address

9804 Moonridge CT
Las Vegas, NV 89134-6737
Phone (650) 204-0726

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
57908CAMDPharmacist
5735NVMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309824000000",
    "number": "1841587425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9804 MOONRIDGE CT",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346737",
            "telephone_number": "650-204-0726",
            "fax_number": "702-202-2506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HILLSHIRE DR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891346365",
            "telephone_number": "650-204-0726",
            "fax_number": "702-202-2506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHERANI",
        "first_name": "SHAMSHUDIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5735",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57908",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; 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.