Active NPI
Samir Shah
- General Practice Dentistry
- Bakersfield, CA
National Provider Identifier
1972933091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 63137
- Practice address
- 2750 Ming Ave
Bakersfield, CA 93304-4431 - Phone
- (661) 396-1701
- NPI assigned
- Nov 27, 2013
- Sex
- Male
- 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 | 63137 | CA | Primary |
Addresses
Primary practice location
2750 Ming Ave
Bakersfield, CA 93304-4431
Mailing address
21001 Sherman Way
Suite 13
Canoga Park, CA 91303-1760
Phone (818) 346-7032
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171226000377 | CA | Order and Referring Only - Dentist | 7416215397 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440892800000",
"number": "1972933091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21001 SHERMAN WAY",
"address_2": "SUITE 13",
"city": "CANOGA PARK",
"state": "CA",
"postal_code": "913031760",
"telephone_number": "818-346-7032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2750 MING AVE",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933044431",
"telephone_number": "661-396-1701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHAH",
"first_name": "SAMIR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-27",
"last_updated": "2015-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "63137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.