Provider Demographics
NPI:1336311406
Name:DR. R. SHAH DENTISTRY PC
Entity Type:Organization
Organization Name:DR. R. SHAH DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJNIKANT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:518-355-5492
Mailing Address - Street 1:1004 PRINCETOWN RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-9766
Mailing Address - Country:US
Mailing Address - Phone:518-355-5492
Mailing Address - Fax:518-357-9928
Practice Address - Street 1:1004 PRINCETOWN RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12306-9766
Practice Address - Country:US
Practice Address - Phone:518-355-5492
Practice Address - Fax:518-357-9928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-29
Last Update Date:2008-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY033326261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental