MEDICARE: RAKHI NUTAN 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	14227894-9926	UT

General Provider Information

NPI Number	:	1801770466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAKHI NUTAN SHAH DDS

Provider Business Mailing Address
First Line	:	655 S SIERRA MADRE ST APT 652
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80903-4295
Country	:	US
Telephone Number	:	248-444-7319
Fax Number	:

Provider Business Practice Location Address
First Line	:	2280 HOGAN ST BLDG 1885
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80913-4433
Country	:	US
Telephone Number	:	719-526-5400
Fax Number	:

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

Provider Enumeration Date	:	08/05/2025
Last Update Date	:	08/05/2025

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