MEDICARE: ANJALI 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	22DI20762	NJ

General Provider Information

NPI Number	:	1457492852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANJALI SHAH DDS

Provider Business Mailing Address
First Line	:	4538 US HIGHWAY 9
Second Line	:
City	:	HOWELL
State	:	NJ
Zip	:	07731-3771
Country	:	US
Telephone Number	:	732-730-8815
Fax Number	:	732-730-8816

Provider Business Practice Location Address
First Line	:	4538 US HIGHWAY 9
Second Line	:
City	:	HOWELL
State	:	NJ
Zip	:	07731-3771
Country	:	US
Telephone Number	:	732-730-8815
Fax Number	:	732-730-8816

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

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/08/2007

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