MEDICARE: MISS MEESHAL 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
1	1223G0001X	General Practice Dentistry	22DI02843900	NJ
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1760010359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MEESHAL SHAH DMD

Provider Business Mailing Address
First Line	:	1914 LINCOLN HWY
Second Line	:	SUITE B
City	:	EDISON
State	:	NJ
Zip	:	08817-3213
Country	:	US
Telephone Number	:	732-724-0805
Fax Number	:	732-724-0878

Provider Business Practice Location Address
First Line	:	1914 LINCOLN HIGHWAY
Second Line	:	SUITE B
City	:	EDISON
State	:	NJ
Zip	:	08817
Country	:	US
Telephone Number	:	732-724-0805
Fax Number	:	732-724-0878

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

Provider Enumeration Date	:	03/30/2020
Last Update Date	:	10/10/2025

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