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General NPI Number Information
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NPI Number | 1396438107
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Entity Type | Individual
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Provider Name | RIA SHAH
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Gender | Female
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Dates
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Enumeration Date | 05/29/2023
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 7516 CITY AVE STE 15
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City | PHILADELPHIA
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State | PA
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Zip | 19151-2102
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Country | US
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Telephone | 267-459-5657
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Fax |
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Provider Business Mailing Address
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Address Line | 301 VILLAGE DR APT 318
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City | KING OF PRUSSIA
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State | PA
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Zip | 19406-3056
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Country | US
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Telephone | 978-201-6394
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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 | DS045188
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License Number State | PA
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