# JESAL SHAH, DMD, P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366985491
- **Authorized official:** DR. JESAL SHAH DMD (PRESIDENT)
- **Authorized official phone:** (516) 395-2659

## Contact information

- **Practice address:** 4609 5TH AVE, 2ND FLOOR, BROOKLYN, NY 11220-1207
- **Practice address phone:** (718) 854-3191
- **Practice address fax:** (718) 909-1635
- **Mailing address:** 4609 5TH AVE, 2ND FLOOR, BROOKLYN, NY 11220-1207
- **Mailing address phone:** (718) 854-3191
- **Mailing address fax:** (718) 909-1635

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 052986 | NY | Yes |

## Other

- **Enumeration date:** 11/21/2016
- **Last updated:** 11/21/2016