Active NPI
Nihar Shah, DMD
- Dentist
- Roselle, IL
National Provider Identifier
1922676790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019033053
- Practice address
- 1530 Lake St
Roselle, IL 60172-3330 - Phone
- (630) 529-0900
- NPI assigned
- Jun 16, 2021
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 019033053 | IL | Primary |
Addresses
Primary practice location
1530 Lake St
Roselle, IL 60172-3330
Mailing address
805 North Lasalle Dr.
Apt 1404
Chicago, IL 60610
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 |
|---|---|---|---|
| 019033053 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bushnell Dental | Current | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Bushnell, IL
- NPI 1205768488
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1623801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1922676790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 NORTH LASALLE DR.",
"address_2": "APT 1404",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1530 LAKE ST",
"city": "ROSELLE",
"state": "IL",
"postal_code": "601723330",
"telephone_number": "630-529-0900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "NIHAR",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-06-16",
"last_updated": "2021-06-16",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019033053",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roselle, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.