Healthcare Provider Details

I. General information

NPI: 1336334382
Provider Name (Legal Business Name): AARTI TUSHAR SHAH D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2007
Last Update Date: 09/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 E ALISAL ST
SALINAS CA
93901-3519
US

IV. Provider business mailing address

128 E ALISAL ST
SALINAS CA
93901-3519
US

V. Phone/Fax

Practice location:
  • Phone: 831-422-6889
  • Fax:
Mailing address:
  • Phone: 831-422-6889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number45189
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number45189
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: