Kinnar Shah, DMD, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN18562188 Issued in MA

Legal business name

KINNAR SHAH, DMD, PC

Doing business as

Southbridge Family Dental

Practice address

305 Main St
Southbridge, MA 01550-3726

Phone

(508) 765-0880

NPI assigned

May 4, 2017

Last updated

May 4, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kinnar Shah, DMD

Title

President

Phone

(215) 385-1003

Specialties & licenses 1

Addresses

Other names 1

• Southbridge Family Dental Doing business as

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

{
    "created_epoch": "1493856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493856000000",
    "number": "1942736434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MAIN ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015503726",
            "telephone_number": "508-765-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MAIN ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015503726",
            "telephone_number": "508-765-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINNAR SHAH, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-04",
        "last_updated": "2017-05-04",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KINNAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-385-1003",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN18562188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southbridge Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sophonie M. Kernizan, RN
• Kwame Kesse
• Eino William Ketola, D.C.
• Albina Kibirova, M.D.
• Emma King
• Kaitlyn Kirk
• Alexandr Kleynerman
• Tasha Ann Klingensmith
• Summer Kunthida Ko-Szych
• Corey Scott Koenig, DO

• General Practice Dentistry in Southbridge, MA
• Providers in Southbridge, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.