Provider Demographics
NPI:1104301282
Name:SHAH, HIRWA SHRENIKBHAI (DMD)
Entity type:Individual
Prefix:DR
First Name:HIRWA
Middle Name:SHRENIKBHAI
Last Name:SHAH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 WORCESTER RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-2158
Mailing Address - Country:US
Mailing Address - Phone:508-640-6040
Mailing Address - Fax:
Practice Address - Street 1:70 WORCESTER RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-2158
Practice Address - Country:US
Practice Address - Phone:508-640-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18581301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice