Healthcare Provider Details

I. General information

NPI: 1427469287
Provider Name (Legal Business Name): DARSHINI SHAH DDS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 05/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2652 ALUM ROCK AVE STE A
SAN JOSE CA
95116-2663
US

IV. Provider business mailing address

2652 ALUM ROCK AVE STE A
SAN JOSE CA
95116-2663
US

V. Phone/Fax

Practice location:
  • Phone: 408-272-4229
  • Fax: 408-272-0900
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number53868
License Number StateCA

VIII. Authorized Official

Name: DARSHINI SHAH
Title or Position: PRESIDENT
Credential: DDS
Phone: 408-272-4229