Provider Demographics
NPI:1952768020
Name:SHAH, DARSHIT (DMD)
Entity Type:Individual
Prefix:
First Name:DARSHIT
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 LAKE CAROLYN PKWY
Mailing Address - Street 2:APT 452
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-4806
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 LAKE CAROLYN PKWY
Practice Address - Street 2:APT 452
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-4806
Practice Address - Country:US
Practice Address - Phone:213-249-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX316031223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics