Provider Demographics
NPI:1104003854
Name:SHAH, KINJAL NIMISH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KINJAL
Middle Name:NIMISH
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 1:2622 ANNAPOLIS ROAD APPLE DENTAL
Mailing Address - Street 2:SUITE-I
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144
Mailing Address - Country:US
Mailing Address - Phone:410-551-7076
Mailing Address - Fax:410-551-7076
Practice Address - Street 1:2622 ANNAPOLIS ROAD APPLE DENTAL
Practice Address - Street 2:SUITE-I
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144
Practice Address - Country:US
Practice Address - Phone:410-551-7076
Practice Address - Fax:410-510-1010
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD130381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice