# KRUPALI SHAH DDS PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bethpage Smiles Family Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225692528
- **Authorized official:** KRUPALI SHAH DDS (PRESIDENT)
- **Authorized official phone:** (773) 407-1004

## Contact information

- **Practice address:** 549 STEWART AVE, BETHPAGE, NY 11714-2706
- **Practice address phone:** (516) 288-8393
- **Mailing address:** 5 WILLETS DR, SYOSSET, NY 11791-3913
- **Mailing address phone:** (773) 407-1004

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/23/2019
- **Last updated:** 04/23/2019