Individual provider Active NPI

Maulik Mahendrabhai Shah, D.D.S.

  • Dentist
  • Riverbank, CA
National Provider Identifier
1851453542
Registry record updated Jul 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50677 Issued in CA
Practice address
2603 Patterson Rd Ste 5
Riverbank, CA 95367-3407
Phone
(209) 315-6300
Fax
(209) 315-6363
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50677 CA Primary

Addresses

Primary practice location

2603 Patterson Rd Ste 5
Riverbank, CA 95367-3407

Mailing address

4116 Dragoo Park Dr
Modesto, CA 95356-1860
Phone (209) 247-3307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160418000808 CA Order and Referring Only - Other (Non-Physician) 9830497338

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maulik Shah,DDS, Inc CurrentSince Nov 13, 2022 Accepting new patients
Maulik Shah Dental Corporation Past Accepting new patients

Locations

2603 Patterson Rd
Ste 5
Riverbank, CA 95367
Phone (209) 315-6300

8014 Lower Sacramento Rd
Ste B
Stockton, CA 95210
Phone (209) 478-9999

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783036800000",
    "number": "1851453542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4116 DRAGOO PARK DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953561860",
            "telephone_number": "209-247-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2603 PATTERSON RD STE 5",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953673407",
            "telephone_number": "209-315-6300",
            "fax_number": "209-315-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "MAULIK",
        "middle_name": "MAHENDRABHAI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2026-07-03",
        "certification_date": "2026-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverbank, CA

Sources for this page

Verify at the official NPI Registry.