# AZURE DENTAL

> 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:** 1386156719
- **Authorized official:** ADITI SHAH DDS (OWNER DENTIST)
- **Authorized official phone:** (817) 809-4445

## Contact information

- **Practice address:** 5611 COLLEYVILLE BLVD STE 140, COLLEYVILLE, TX 76034-6069
- **Practice address phone:** (817) 809-4445
- **Mailing address:** 5611 COLLEYVILLE BLVD STE 140, COLLEYVILLE, TX 76034-6069
- **Mailing address phone:** (817) 809-4445

## Taxonomy

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

## Other

- **Enumeration date:** 10/25/2017
- **Last updated:** 10/25/2017