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General NPI Number Information
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NPI Number | 1366652752
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Entity Type | Individual
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Provider Name | TANVI MAHIPAL SHAH DDS
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8201 EDGEWATER DR STE 105
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City | OAKLAND
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State | CA
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Zip | 94621-2021
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Country | US
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Telephone | 510-568-3577
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Fax |
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Provider Business Mailing Address
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Address Line | 229 BRANNAN ST UNIT 17E
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City | SAN FRANCISCO
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State | CA
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Zip | 94107-4061
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Country | US
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Telephone | 415-515-9581
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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 | 51136
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License Number State | CA
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