Jayshree Shah DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

34900 Issued in CA

Legal business name

JAYSHREE SHAH DDS INC

Practice address

301 W Bastanchury Rd
Ste 5
Fullerton, CA 92835-3419

Phone

(714) 871-4892

NPI assigned

May 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jayshree N Shah, DDS

Title

Ceo

Phone

(714) 871-4892

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Jayshree N Shah DDS Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Jayshree N. Shah DDS, Inc.

  dba Vivid Dental Studio

  • General Practice Dentistry
  • Fullerton, CA
  • NPI 1114176609
  NPD tax ID

Locations

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431388800000",
    "number": "1861870735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "STE 5",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-871-4892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W BASTANCHURY RD",
            "address_2": "STE 5",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928353419",
            "telephone_number": "714-871-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYSHREE SHAH DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-12",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "JAYSHREE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-871-4892",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "34900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "B34900",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Jasso
• Edith Jauregui Vargas
• Maica De Vera Javien, NP-C
• David Jawor, D.D.S.
• Jayshree N. Shah DDS, Inc. (Vivid Dental Studio)
• Jazstrom, Inc (Aid to Ride)
• JC Cottages LLC
• Ayerjenee Alex Jeanmard, HS
• Jeff Kaku, O.D., Inc.
• Jeffrey V. Winston, MD a Professional Corp (Winston Eye Care)

• Dentist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2015; 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.