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NPI Code Detail

MEDICARE: DR. KIRTIDA J SHAH D.D.S.

MEDICARE: DR. KIRTIDA J SHAH D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist034566NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1023105293
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIRTIDA J SHAH D.D.S.
Provider Business Mailing Address
First Line : 20 ILINKA LN
Second Line :
City : IRVINGTON
State : NY
Zip : 10533-2333
Country : US
Telephone Number : 914-591-6770
Fax Number :
Provider Business Practice Location Address
First Line : 3455 BOSTON RD
Second Line :
City : BRONX
State : NY
Zip : 10469-2508
Country : US
Telephone Number : 718-798-2236
Fax Number : 718-798-0561
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 07/08/2007

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