Active NPI
Rajul M Shah, D.D.S.
- General Practice Dentistry
- San Jacinto, CA
National Provider Identifier
1912056722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 50823
- Practice address
- 701 W Esplanade Ave
Ste K & L
San Jacinto, CA 92582-4540 - Phone
- (951) 654-3424
- Fax
- (951) 654-9423
- NPI assigned
- Jan 10, 2007
- Last updated
- Dec 19, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 50823 | CA | Primary |
Addresses
Primary practice location
701 W Esplanade Ave
Ste K & L
San Jacinto, CA 92582-4540
Mailing address
17586 Dry Run CT
Riverside, CA 92504-8820
Phone (951) 300-8171
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 193230807902 | Medicaid | CA | |
| 193230807901 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 50823 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rajul Shah Dental Corporation | General Practice | Past | Accepting new patients |
| San Jacinto Dental Group | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- San Jacinto, CA
- NPI 1497184675
-
- Dentist
- San Jacinto, CA
- NPI 1538350806
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387411200000",
"number": "1912056722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17586 DRY RUN CT",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925048820",
"telephone_number": "951-300-8171",
"fax_number": "951-654-9423"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "701 W ESPLANADE AVE",
"address_2": "STE K & L",
"city": "SAN JACINTO",
"state": "CA",
"postal_code": "925824540",
"telephone_number": "951-654-3424",
"fax_number": "951-654-9423"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "RAJUL",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2013-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "50823",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "193230807902",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "193230807901",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Jacinto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.