Provider Demographics
NPI:1720270580
Name:SHAH, MEGHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MEGHA
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 1:1144 HOOPER AVE
Mailing Address - Street 2:SUITE 201B
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-8361
Mailing Address - Country:US
Mailing Address - Phone:732-264-8004
Mailing Address - Fax:
Practice Address - Street 1:3034 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1505
Practice Address - Country:US
Practice Address - Phone:732-264-8004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-15
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI023582001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry