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DR. SHYAM A. SHAH D.M.D.
NPI 1104206010
Dentist in Newark, NJ

Active since June 05, 2015PECOS Enrolled
110 BERGEN ST RM B-854, NEWARK, NJ 07103(973) 972-4717 Get Directions Write a Review

NPPES record last updated: November 14, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 14, 2019, Mar 17, 2018, Jul 26, 2017 and 1 more (4 updates tracked since 2016).

About Dr. Shyam A. Shah D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHYAM A. SHAH D.M.D. (NPI 1104206010) is an individual dentist in Newark, New Jersey, licensed in New Jersey (22DI02605700) and active in the NPI registry since June 2015. He is enrolled in Medicare PECOS and maintains a secondary practice location in Little Falls.

NPPES Registry Identity

NPI1104206010
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. SHYAM A. SHAHCredential: D.M.D.
Location Address110 BERGEN ST RM B-854Newark, NJ 07103-2495
Mailing Address110 Bergen St Rm B-854Newark, NJ 07103-2495 · (973) 972-4717
Phone(973) 972-4717
Sole ProprietorNo
Enumeration DateJune 5, 2015
Last NPPES UpdateNovember 14, 20194 updates tracked since enumeration
✔ NPI 1104206010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in NJ · 22DI02605700
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
110 BERGEN ST RM B-854, Newark, NJ 07103
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Secondary Practice Location 1

Location 1245 Paterson AveLittle Falls, NJ 07424-4629 · Phone (973) 256-3912

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Shyam A. Shah D.m.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$98.09 typical visit price
range $63.84 – $190.92
Typical copayment $24.52 (range $15.96 – $47.73)
Most-billed visit code 99203
Established Patient
$79.09 typical visit price
range $20.97 – $155.92
Typical copayment $19.77 (range $5.24 – $38.98)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MAX LIU DDS
Student in an Organized Health Care Education/Training Program
110 BERGEN ST RM B-854
NEWARK, NJ 07103
Essex County (972) 972-3126
RABIE M SHANTI DMD, MD
Oral & Maxillofacial Surgery
110 BERGEN ST RM B-854
NEWARK, NJ 07103
Essex County (739) 972-3126

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shyam Shah's NPI number?

The NPI number for Shyam Shah is 1104206010. It was assigned to this individual provider in the NPPES registry on June 5, 2015.

Where is Shyam Shah located?

Shyam Shah practices at 110 Bergen St Rm B-854, Newark, NJ 07103. The listed phone number is (973) 972-4717.

What is Shyam Shah's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Shyam Shah enrolled in Medicare?

Yes. Shyam Shah is registered in the Medicare PECOS enrollment system.

What insurance does Shyam Shah accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Shyam Shah as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Shyam Shah was last updated on November 14, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.