Kishore Shah, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30003 Issued in CA

Practice address

21001 Sherman Way Ste 13
Canoga Park, CA 91303-3680

Phone

(818) 346-7032

Fax

(818) 346-4835

NPI assigned

Jan 17, 2007

Last updated

Sep 12, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1871645101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21001 SHERMAN WAY STE 13",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033680",
            "telephone_number": "818-346-7032",
            "fax_number": "818-346-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21001 SHERMAN WAY STE 13",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913033680",
            "telephone_number": "818-346-7032",
            "fax_number": "818-346-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "KISHORE",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilgar Seyedi
• Rami M Shaarawy, M.D.
• Michael Shackelford
• Christopher Damian Shafer, DC
• Kavita A Shah, D.D.S.
• Irene Shahvosian
• Dania Shaian
• Maryam Shamaei-Tousi, M.A.
• Edwin Shamtob
• Ashley Marie Shanburn

• General Practice Dentistry in Canoga Park, CA
• Providers in Canoga Park, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; 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.