Meridian Dental Associates

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MERIDIAN DENTAL ASSOCIATES

Practice address

1241 Meridian Avenue
San Jose, CA 95125

Phone

(408) 266-6144

Fax

(408) 676-4443

NPI assigned

May 16, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Raoul R Shah, DDS

Title

Owner

Phone

(408) 266-6144

Specialties & licenses 8

Addresses

Other names 1

• Willow Glen Dental Center Doing business as

Locations

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

{
    "created_epoch": "1494892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715212800000",
    "number": "1982131306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 MERIDIAN AVENUE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95125",
            "telephone_number": "408-266-6144",
            "fax_number": "408-676-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 MERIDIAN AVENUE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95125",
            "telephone_number": "408-266-6144",
            "fax_number": "408-676-4443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-16",
        "last_updated": "2024-05-09",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "RAOUL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-266-6144",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willow Glen Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Willow Glen Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alexandra Sierra Meriales
• Lander Merida Gonzales
• Meridian Acupuncture
• Meridian Acupuncture
• Meridian Acupuncture and Herb
• Meridian Medical Group Professional Corp
• Meridian Treatment Acupuncture Corp
• Maria Merino
• Max Kai Merrill-Hypko
• Poupak Merrill, PH.D.

• General Practice Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2024; 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.