Provider Demographics
NPI:1043549074
Name:SHAH, CHHAYA D (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHHAYA
Middle Name:D
Last Name:SHAH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:242 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:ULSTER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12487-5119
Mailing Address - Country:US
Mailing Address - Phone:845-514-2886
Mailing Address - Fax:
Practice Address - Street 1:242 RIVER RD
Practice Address - Street 2:
Practice Address - City:ULSTER PARK
Practice Address - State:NY
Practice Address - Zip Code:12487-5119
Practice Address - Country:US
Practice Address - Phone:845-514-2886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0349091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice