MEDICARE: DR. KARNIK SHAH BDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	32429	TX

General Provider Information

NPI Number	:	1013468529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARNIK SHAH BDS, MS

Provider Business Mailing Address
First Line	:	412 STAUNTON DR
Second Line	:
City	:	LEANDER
State	:	TX
Zip	:	78641-5471
Country	:	US
Telephone Number	:	614-779-5126
Fax Number	:

Provider Business Practice Location Address
First Line	:	1923 E 7TH ST STE 120
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78702-3453
Country	:	US
Telephone Number	:	512-236-9300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2016
Last Update Date	:	03/22/2024

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