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Organization
MERIDIAN DENTAL ASSOCIATES
Active
Organization
MERIDIAN DENTAL ASSOCIATES
Active
Other names
Willow Glen Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAOUL R SHAH DDS (OWNER)
(408) 266-6144
Entity
Organization
Contact information
Practice address
1241 MERIDIAN AVENUE, SAN JOSE, CA 95125
(408) 266-6144
(408) 676-4443
Mailing address
1241 MERIDIAN AVENUE, SAN JOSE, CA 95125
(408) 266-6144
(408) 676-4443
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
05/16/2017
Last updated
05/09/2024
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