Provider Demographics
NPI:1659627685
Name:DOSHI, BIJAL SHAH (DMD)
Entity Type:Individual
Prefix:
First Name:BIJAL
Middle Name:SHAH
Last Name:DOSHI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5504 WESTBARD AVE
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20816-3344
Mailing Address - Country:US
Mailing Address - Phone:630-709-3775
Mailing Address - Fax:
Practice Address - Street 1:5504 WESTBARD AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20816-3344
Practice Address - Country:US
Practice Address - Phone:630-709-3775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY056154122300000X
IL019029221122300000X
VA0401413903122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist