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General NPI Number Information
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NPI Number | 1952086860
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Entity Type | Individual
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Provider Name | MAITRI SHAH DDS
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Gender | Female
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Dates
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Enumeration Date | 06/19/2023
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 151 MERIDIAN ST
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City | EAST BOSTON
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State | MA
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Zip | 02128-1675
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Country | US
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Telephone | 857-322-1011
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Fax |
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Provider Business Mailing Address
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Address Line | 8 MUSEUM WAY APT 708
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City | CAMBRIDGE
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State | MA
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Zip | 02141-1879
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Country | US
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Telephone | 857-753-7856
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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 | DN1859915
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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