Individual provider Active NPI

Priya Ilesh Shah, DDS

  • Dentist
  • Niles, IL
National Provider Identifier
1841920667
Registry record updated Feb 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019.035046 Issued in IL
Practice address
7942 W Oakton St
Niles, IL 60714-2400
Phone
(847) 823-0260
NPI assigned
Jun 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12013814A IN
Dentist 122300000X 019.035046 IL Primary

Addresses

Primary practice location

7942 W Oakton St
Niles, IL 60714-2400

Mailing address

360 W Hubbard St Apt 1809
Chicago, IL 60654-5752
Phone (219) 794-6333

Other practice location 1

417 Ridge Rd Ste A
Munster, IN 46321-1571
Phone (219) 552-7674

Other practice location 2

11055 Broadway Ste E
Crown Point, IN 46307-7300
Phone (219) 488-2610

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
019.035046ILMDDentist
12013814AINMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Priya Shah DDS PLLC Dentist CurrentSince Feb 23, 2025 Accepting new patients
Lamantia & Mazanek LTD. PastSince Feb 23, 2025 Accepting new patients

Locations

7942 W Oakton St
Niles, IL 60714
Phone (847) 823-0260

Organizations & group practices 2

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": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739232000000",
    "number": "1841920667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W HUBBARD ST APT 1809",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545752",
            "telephone_number": "219-794-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7942 W OAKTON ST",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607142400",
            "telephone_number": "847-823-0260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "417 Ridge Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Munster",
            "state": "IN",
            "postal_code": "463211571",
            "country_code": "US",
            "telephone_number": "219-552-7674",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11055 Broadway Ste E",
            "address_purpose": "LOCATION",
            "city": "Crown Point",
            "state": "IN",
            "postal_code": "463077300",
            "country_code": "US",
            "telephone_number": "219-488-2610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "PRIYA",
        "middle_name": "ILESH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-14",
        "last_updated": "2025-02-11",
        "certification_date": "2025-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12013814A",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.035046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2025; 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.