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General NPI Number Information
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NPI Number | 1598387383
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Entity Type | Individual
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Provider Name | JUHI SHAH
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Gender | Female
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 02/09/2024
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Provider Practice Location Address
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Address Line | 475 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3436
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Country | US
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Telephone | 919-308-9995
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Fax |
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Provider Business Mailing Address
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Address Line | 132 MONTFORT DR
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City | BELLE MEAD
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State | NJ
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Zip | 08502-4808
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Country | US
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Telephone | 919-308-9995
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 062764-01
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License Number State | NY
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