Individual
DHAVAL JAYMIN SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
634 ANDERSON AVE, CLIFFSIDE PARK, NJ 07010-1811
(201) 945-1119
Mailing address
965 LAKEVILLE RD, NEW HYDE PARK, NY 11040-3008
(516) 320-4845
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
22DI03029400
NJ
1223P0221X
Pediatric Dentistry
Primary
22DI03029400
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/07/2022
Last updated
07/01/2024
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