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General NPI Number Information
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NPI Number | 1326699851
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Entity Type | Individual
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Provider Name | AMI SHAH DMD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2019
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Last Update Date | 12/26/2022
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Provider Practice Location Address
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Address Line | 647 ROUTE 18 STE A
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3747
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Country | US
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Telephone | 732-487-3210
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Fax | 732-686-0015
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Provider Business Mailing Address
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Address Line | 14 HILLTOP BLVD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-2832
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Country | US
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Telephone | 813-842-5953
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI02763800
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License Number State | NJ
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