KISHORE SHAH DDS INC.
Complete NPI Record 1003012170
Dentist - General Practice in Pacoima, CA

NPI Status: Active since June 25, 2007

Contact Information

13277 VANY NUYS BLVD UNIT A
PACOIMA, CA
ZIP 91331
Phone: (818) 899-2505
Fax: (818) 899-2507

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Complete NPI Dataset

The following table represents the complete dataset for NPI number 1003012170. The table includes a list of all field names, values and definitions of the full NPI record. This dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.

Name Value Definition
NPI1003012170The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameCARE NOW DENTALThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider Other Organization NameKISHORE SHAH DDS INC.Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code5Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address13277 VAN NUYS BLVD UNIT AThe first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NamePACOIMAThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameCAThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code91331The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number8188992505The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number8188992507The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address13277 VANY NUYS BLVD UNIT AThe first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePACOIMAThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameCAThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code91331The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number8188992505The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number8188992507The fax number associated with the location address of the provider being identified.
Provider Enumeration Date6/25/2007The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date5/15/2015The date that a record was last updated or changed.
Authorized Official Last NameSHAHThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameKISHOREThe first name of the authorized official.
Authorized Official Middle NameK.The middle name of the authorized official.
Authorized Official Title or PositionOWNERThe title or position of the authorized official.
Authorized Official Telephone Number8188992505The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 11223G0001XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 130003The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1CAThe code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1Y
Is Organization SubpartY
Parent Organization LBNKISHORE SHAH DDS INC.
Parent Organization TINUNAVAIL
Authorized Official Credential TextD.D.S.
Healthcare Provider Taxonomy Group 1193200000X MULTI-SPECIALTY GROUP