Provider Demographics
NPI:1306191234
Name:SHAH, PALAK PARIKH (DDS)
Entity Type:Individual
Prefix:DR
First Name:PALAK
Middle Name:PARIKH
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 1:6520 LIMERICK CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21029-1546
Mailing Address - Country:US
Mailing Address - Phone:443-745-1176
Mailing Address - Fax:
Practice Address - Street 1:6345 WOODSIDE CT STE 103
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-3224
Practice Address - Country:US
Practice Address - Phone:104-312-5660
Practice Address - Fax:410-312-5662
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD151201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice