Active NPI
Khushbu Divyeshkumar Shah, DDS
- General Practice Dentistry
- North Brunswick, NJ
National Provider Identifier
1972174472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS043287
- Practice address
- 12 Pin Oak Dr
North Brunswick, NJ 08902-5525 - Phone
- (732) 789-5507
- NPI assigned
- Jul 6, 2021
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS043287 | PA | Primary |
Addresses
Primary practice location
12 Pin Oak Dr
North Brunswick, NJ 08902-5525
Mailing address
12 Pin Oak Dr
North Brunswick, NJ 08902-5525
Phone (732) 789-5507
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 |
|---|---|---|---|
| DS043287 | PA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628726400000",
"number": "1972174472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 PIN OAK DR",
"city": "NORTH BRUNSWICK",
"state": "NJ",
"postal_code": "089025525",
"telephone_number": "732-789-5507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 PIN OAK DR",
"city": "NORTH BRUNSWICK",
"state": "NJ",
"postal_code": "089025525",
"telephone_number": "732-789-5507"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "KHUSHBU",
"middle_name": "DIVYESHKUMAR",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-07-06",
"last_updated": "2021-08-12",
"certification_date": "2021-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS043287",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Brunswick, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.