Provider Demographics
NPI:1821545385
Name:SHAH, SHASHI NARESH (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHASHI
Middle Name:NARESH
Last Name:SHAH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 E HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-3680
Mailing Address - Country:US
Mailing Address - Phone:551-998-1675
Mailing Address - Fax:
Practice Address - Street 1:125 E RAY RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-3339
Practice Address - Country:US
Practice Address - Phone:480-566-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD011100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist