Individual provider Active NPI

Dipika T Shah, DDS, MAGD

  • General Practice Dentistry
  • Holmdel, NJ
National Provider Identifier
1992779706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19535 Issued in NJ
Practice address
723 N Beers St
Suite 2 F
Holmdel, NJ 07733-1517
Phone
(732) 264-8180
Fax
(732) 264-5193
NPI assigned
Feb 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19535 NJ Primary

Addresses

Primary practice location

723 N Beers St
Suite 2 F
Holmdel, NJ 07733-1517

Mailing address

723 N Beers St
Suite 2 F
Holmdel, NJ 07733-1517
Phone (732) 264-8180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150818005146 NJ Practitioner - Oral Surgery 8729390703 Practice locations: Holmdel, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19535NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992779706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "723 N BEERS ST",
            "address_2": "SUITE 2 F",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331517",
            "telephone_number": "732-264-8180",
            "fax_number": "732-264-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "723 N BEERS ST",
            "address_2": "SUITE 2 F",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331517",
            "telephone_number": "732-264-8180",
            "fax_number": "732-264-5193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "DIPIKA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS, MAGD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "19535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.