Provider Demographics
NPI:1427239508
Name:SHAH, RUPAL D (DMD)
Entity type:Individual
Prefix:DR
First Name:RUPAL
Middle Name:D
Last Name:SHAH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:RUPAL
Other - Middle Name:D
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:710 ABBI RD
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-3543
Mailing Address - Country:US
Mailing Address - Phone:561-267-6408
Mailing Address - Fax:
Practice Address - Street 1:245 PATERSON AVE
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07424-4629
Practice Address - Country:US
Practice Address - Phone:973-256-3912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-17
Last Update Date:2007-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02361700122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist