Provider Demographics
NPI:1467861823
Name:SHAH, ERIN (DDS)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
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 1:435 CHINA BASIN ST UNIT 529
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2172
Mailing Address - Country:US
Mailing Address - Phone:773-383-2741
Mailing Address - Fax:
Practice Address - Street 1:2001 UNION ST STE 450
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4137
Practice Address - Country:US
Practice Address - Phone:415-922-2992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-10
Last Update Date:2014-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63630122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist