K J Shah DDS, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

K J SHAH DDS, INC.

Practice address

521 W Channel Islands Blvd Ste 8
Port Hueneme, CA 93041-2132

Phone

(805) 815-4356

NPI assigned

Mar 7, 2007

Organization subpart

No

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

Authorized official

Name

Kosha Shah, D.D.S.NPI 1669503397

Title

President

Phone

(805) 815-4356

Specialties & licenses 1

Addresses

Other names 1

• Landmark Family Dental Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kosha Shah, D.D.S.

  • Dentist
  • Port Hueneme, CA
  • NPI 1669503397
  NPD (past) Authorized official
• Rutu Jignesh Shah, DDS

  • Dentist
  • Port Hueneme, CA
  • NPI 1053929976
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922139641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 W CHANNEL ISLANDS BLVD STE 8",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930412132",
            "telephone_number": "805-815-4356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 W CHANNEL ISLANDS BLVD STE 8",
            "city": "PORT HUENEME",
            "state": "CA",
            "postal_code": "930412132",
            "telephone_number": "805-815-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K J SHAH DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KOSHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-815-4356",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Landmark Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Suleiman Jangikhan, PHARMD
• Gyutae Jin, DMD
• Fernando Juarez, OTHER
• Piotor Juchniewicz, IDC
• Jason Jung, DO
• Shawn Jeremy Kern
• Timothy J. Kerr, DIVE IDC
• Erik Christian Ketelsen, IDC
• James A Kirk, MPT
• Ryan Kitchens

• General Practice Dentistry in Port Hueneme, CA
• Providers in Port Hueneme, 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 Aug 22, 2020; 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.