Individual provider Active NPI

Ehfad M Shah, DMD

  • General Practice Dentistry
  • Maricopa, AZ
National Provider Identifier
1932280500
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D5848 Issued in AZ
Practice address
44600 W Smith Enke Rd
Suite 103
Maricopa, AZ 85239-5442
Phone
(520) 494-7333
Fax
(520) 494-7374
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D5848 AZ Primary

Addresses

Primary practice location

44600 W Smith Enke Rd
Suite 103
Maricopa, AZ 85239-5442

Mailing address

44600 W Smith Enke Rd
Suite 103
Maricopa, AZ 85239-5442
Phone (520) 494-7333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150722003344 AZ Order and Referring Only - DentistPractitioner - Dentist 0941513857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D5848AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932280500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44600 W SMITH ENKE RD",
            "address_2": "SUITE 103",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "852395442",
            "telephone_number": "520-494-7333",
            "fax_number": "520-494-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44600 W SMITH ENKE RD",
            "address_2": "SUITE 103",
            "city": "MARICOPA",
            "state": "AZ",
            "postal_code": "852395442",
            "telephone_number": "520-494-7333",
            "fax_number": "520-494-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "EHFAD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D5848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maricopa, AZ

Sources for this page

Verify at the official NPI Registry.