Raveena Shah, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019.032683 Issued in IL

Practice address

11238 S Western Ave
Chicago, IL 60643-4116

Phone

(708) 388-0001

NPI assigned

Apr 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1587168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1962022095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11238 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11238 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434116",
            "telephone_number": "708-388-0001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532332186",
            "country_code": "US",
            "telephone_number": "414-288-6790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAVEENA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-18",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Puja Shah, O.D
• Radha Shah, DO
• Rahi Rajendra Shah, DO
• Raj C Shah, M.D.
• Ranchhodlal S. Shah, M.D.
• Ravi Dipak Shah, MD
• Rebecca Gloria Shah, APN-CNP
• Reena Shah
• Reena P Shah, DDS
• Reena P Shah, DDS

• General Practice Dentistry in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.