Healthcare Provider Details

I. General information

NPI: 1801770466
Provider Name (Legal Business Name): RAKHI NUTAN SHAH DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SUDLAGER 250
VILSECK BAVARIA
92249
DE

IV. Provider business mailing address

CMR 411 BOX 969
APO AE
09112-1010
US

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14227894-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: