MEDICARE: DHARA H SHAH

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
1	1223G0001X	General Practice Dentistry	38376	TX

General Provider Information

NPI Number	:	1215500251
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DHARA H SHAH

Provider Business Mailing Address
First Line	:	10608 PLUCHEA CV
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78733-5721
Country	:	US
Telephone Number	:	737-206-1611
Fax Number	:

Provider Business Practice Location Address
First Line	:	6405 S INTERSTATE 35 STE E
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-4219
Country	:	US
Telephone Number	:	512-640-7999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2021
Last Update Date	:	02/12/2026

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Directions to “ DHARA H SHAH ” Practice Location

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