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General NPI Number Information
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NPI Number | 1326513771
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Entity Type | Organization
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Legal Business Name | AMIT A SHAH DDS INC
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Dates
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Enumeration Date | 10/11/2018
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Last Update Date | 10/11/2018
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Provider Practice Location Address
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Address Line | 18377 BEACH BLVD STE 216
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92648-1349
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Country | US
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Telephone | 714-698-9950
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Fax |
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Provider Business Mailing Address
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Address Line | 9656 TURTLEDOVE AVE
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-5877
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Country | US
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Telephone | 858-449-4987
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMIT A. SHAH
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Credential | DDS
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Telephone | 858-449-4987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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