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NPI Code Detail

MEDICARE: BINITA SHAH

MEDICARE: BINITA SHAH
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
1122300000XDentist32612TX
2122300000XDentist11703CT
3390200000XStudent in an Organized Health Care Education/Training Program
41223G0001XGeneral Practice Dentistry101706CA

General Provider Information

NPI Number : 1356793814
Entity Type Code : Individual
Provider Name (Legal Business Name) : BINITA SHAH
Provider Business Mailing Address
First Line : 201 E LAKEVIEW AVE
Second Line :
City : WOODLAKE
State : CA
Zip : 93286-1301
Country : US
Telephone Number : 954-292-6836
Fax Number :
Provider Business Practice Location Address
First Line : 201 E LAKEVIEW AVE
Second Line :
City : WOODLAKE
State : CA
Zip : 93286-1301
Country : US
Telephone Number : 877-960-3426
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2016
Last Update Date : 09/02/2021

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Directions to “ BINITA SHAH ” Practice Location

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