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General NPI Number Information
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NPI Number | 1497491799
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Entity Type | Individual
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Provider Name | CHARMI SHAH DMD
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Gender | Female
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Dates
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Enumeration Date | 05/09/2022
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Last Update Date | 05/09/2022
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Provider Practice Location Address
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Address Line | 2301 E ALLEGHENY AVE STE 300M
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City | PHILADELPHIA
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State | PA
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Zip | 19134-4427
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Country | US
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Telephone | 267-529-0990
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Fax |
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Provider Business Mailing Address
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Address Line | 231 CROSSWICKS RD STE 9
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City | BORDENTOWN
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State | NJ
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Zip | 08505-2602
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Country | US
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Telephone | 609-291-8555
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 22DI02798600
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License Number State | NJ
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