MEDICARE: DARSHINI SHAH DDS INC.

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	305R00000X	Preferred Provider Organization	53868	CA

General Provider Information

NPI Number	:	1427469287
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DARSHINI SHAH DDS INC.

Provider Business Mailing Address
First Line	:	2652 ALUM ROCK AVE STE A
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-2663
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2652 ALUM ROCK AVE STE A
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-2663
Country	:	US
Telephone Number	:	408-272-4229
Fax Number	:	408-272-0900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DARSHINI SHAH
Credential	:	DDS
Telephone Number	:	408-272-4229

Provider Enumeration Date	:	05/14/2014
Last Update Date	:	05/14/2014

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