Provider Demographics
NPI:1457621716
Name:SHAH, SHALIN RAJ (DMD, MS)
Entity Type:Individual
Prefix:
First Name:SHALIN
Middle Name:RAJ
Last Name:SHAH
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:UNIT #1 (CENTER FOR ORTHODONTIC EXCELLENCE)
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1120
Mailing Address - Country:US
Mailing Address - Phone:609-799-4628
Mailing Address - Fax:609-799-4760
Practice Address - Street 1:61 PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:UNIT #1 (CENTER FOR ORTHODONTIC EXCELLENCE)
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-1120
Practice Address - Country:US
Practice Address - Phone:609-799-4628
Practice Address - Fax:609-799-4760
Is Sole Proprietor?:No
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0369451223X0400X
NJ22DI023267001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics