MEDICARE: DR. SHILPA A SHAH DDS

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	019520	NJ

General Provider Information

NPI Number	:	1255422721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHILPA A SHAH DDS

Provider Business Mailing Address
First Line	:	3 PARLIN DR
Second Line	:	SUITE H
City	:	PARLIN
State	:	NJ
Zip	:	08859-2263
Country	:	US
Telephone Number	:	732-238-8151
Fax Number	:	732-238-8979

Provider Business Practice Location Address
First Line	:	3 PARLIN DR
Second Line	:	SUITE H
City	:	PARLIN
State	:	NJ
Zip	:	08859-2263
Country	:	US
Telephone Number	:	732-238-8151
Fax Number	:	732-238-8979

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

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/08/2007

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