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NPI Code Detail

MEDICARE: DR. ADVAIT V. SHAH DMD

MEDICARE: DR. ADVAIT V. SHAH DMD
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
1122300000XDentist053576NY
2122300000XDentist15215MD
3122300000XDentist0401413923VA

General Provider Information

NPI Number : 1285704056
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADVAIT V. SHAH DMD
Provider Business Mailing Address
First Line : 16 GREENMEADOW DR
Second Line : SUITE 205
City : TIMONIUM
State : MD
Zip : 21093-3200
Country : US
Telephone Number : 410-308-9955
Fax Number : 410-308-9980
Provider Business Practice Location Address
First Line : 16 GREENMEADOW DR
Second Line : SUITE 205
City : TIMONIUM
State : MD
Zip : 21093-3200
Country : US
Telephone Number : 410-308-9955
Fax Number : 410-308-9980
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2006
Last Update Date : 06/04/2015

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